Home Chapter Home Jobs Conferences Fellowships Books
Breast-malignant, males, children
Morphologic variants of DCIS
Spindle cell ductal carcinoma in situ
Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.
Reviewer: Daniel Visscher, M.D., University of Michigan Hospitals, February 2009 (see Reviewers page)
Revised: 30 August 2009
Last major update: August 2009
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
=========================================================================
● May be a variant of neuroendocrine DCIS (Zhonghua Bing Li Xue Za Zhi 2006;35:13)
● Invasive tumors are considered a subset of metaplastic carcinoma
Epidemiology
=========================================================================
● Very rare (0.1% of breast carcinomas)
● Mean age 59 years
Symptoms
=========================================================================
● Nipple discharge, breast lump or mammographic abnormality
Gross description
=========================================================================
● 3 to 41 mm
Microscopic description / grading
=========================================================================
● 10-80% of DCIS cells are spindled; patterns are fascicular, streaming or papillary
● Usually low nuclear grade, with variable necrosis and microinvasion (Histopathology 2004;45:343)
Cytology description
=========================================================================
● Predominantly clusters and a small population of single cells in a necrotic background
● Cells are mostly spindled, with minor population of epithelioid cells
● Cells have high N/C ratio with hyperchromatic and pleomorphic nuclei and prominent nucleoli
● Resembles metaplastic carcinoma (Acta Cytol 2005;49:323)
Positive stains
=========================================================================
● Usually synaptophysin or chromogranin
● ER, PR
Negative stains
=========================================================================
● HER2, HMW keratin, smooth muscle actin
Differential diagnosis
=========================================================================
● Florid hyperplasia - HMW keratin+
● Intraductal papilloma - no atypia
● Metaplastic spindle cell tumors associated with fibrosclerotic lesions (Mod Path 2003;16:893)
● Myoepithelial hyperplasia - p63+, S100+, smooth muscle actin+
Additional references
=========================================================================
End of Breast – Malignant, Males, Children > Spindle cell ductal carcinoma in situ
This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must also be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.
All information on this website is protected by Copyright, (c) 2001-2009, PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions.