Abstract
The authors describe the characteristics of atypical cystic lobules (ACLs), which represent a step in the formation of low-grade ductal carcinomain-situ. The authors define ACLs as a proliferation of luminal cells showing low-grade cytological atypia without architectural atypia. ACLs were compared with conventional hyperplasia, low-grade ductal carcinomain-situ, and lobular neoplasia. 1) In about 40% of the cases, atypical cystic lobules merged with fully established micropapillary/cribriform ductal carcinomain-situ.2) Immunohistochemical staining for hormone receptors, keratin nineteen, and cyclin D1 revealed that atypical cystic lobules demonstrate a consistent immunophenotype, which differs from that of normal lobules and benign lesions and matches the one of low-grade ductal carcinoma in-situ. 3) ACLs are sometimes calcified. Osteopontin-positive histiocytes infiltrated all Kossa-positive (type II microcalcification) cribriform and comedo-type carcinomas and ACLs. The similarities in cytological and immunohistochemical features, the close proximity of the two types of proliferation, and the similarities with respect to calcification suggest that atypical cystic lobules represent an early stage in the formation of certain types of low-grade ductal carcinomain-situ.
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References
Azzopardi JG: Problems in breast pathology. W. B. Saunders Company, Philadelphia, 1979.
Eusebi V, Feudale E, Foschini MPet al: Long-term follow-up of in situ carcinoma of the breast.Sent Diagn Pathol 11:223–235, 1994.
Eusebi V, Forchini MP, Cook MGet al: Long-term follow-up of in situ carcinoma of the breast with special emphasis on clinging carcinoma.Sent Diagn Pathol 6:165–73, 1989.
Fraser JL, Raza S, Chorny Ket al: Columnar alteration with prominent apical snouts and secretions. A spectrum of changes frequently present in breast biopsies performed for microcalcifications.Ant J Surg Pathol 22:1521–1527, 1998.
Tavassoli FA: Ductal carcinomain situ: Introduction of the concept of ductal intraepithelial neoplasia.Mod Pathol 11:140–154, 1998.
Tsuchiya S: Atypical ductal hyperplasia, atypical lobular hyperplasia, and interpretation of a new borderline lesion.Jpn J Cancer Clin 44:548–555, 1998.
Hoshi K, Mochizuki M, Otaka T,et al: Stereomicroscopic study of atypical lobules in low papillary carcinomas,Jpn J Cancer Res Suppl (Proceeding of the Japanese Cancer Association 50th Annual Meeting, Tokyo): 321, 1991.
Oyama T, Maluf H, Koerner F: Atypical cystic lobules: an early stage in the formation of low-grade ductal carcinomain situ.Virchows Arch 435:413–421, 1999.
Frappart L, Remy I, Lin HC,et al: Different types of microcalcifications observed in breast pathology. Correlations with histopathological diagnosis and radiological examination of operative specimens.Virchows Arch A Pathol Anat Histopathol 410:179–187, 1986.
Gonzalez JE, Caldwell RG, Valaitis J: Calcium oxalate crystals in the breast. Pathology and significance.Am J Surg Pathol 15:586–591, 1991.
Rogers LW: Epithelial hyperplasia. In: Page DL, Anderson TJ (eds) Diagnostic histopathology of the breast. Churchhill Livingstone, New York, 1987.
Page DL, Kasami M, Jensen R: Hypersecretory Hyperplasia with atypia in breast biopsies, what is the proper level of clinical concern?Pathology case Reviews May/June 1:36–40, 1996.
Moinfar F, Man YG, Bratthauer GLet al:Genetic abnormalities in mammary ductal intraepithelial neoplasia-flat type (“clinging ductal carcinomain situ”): A simulator of normal mammary epithelium.Cancer 88:2072–2081, 2000.
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Oyama, T., lijima, K., Takei, H. et al. Atypical cystic lobule of the breast: An early stage of low-grade ductal carcinomain-situ . Breast Cancer 7, 326–331 (2000). https://doi.org/10.1007/BF02966399
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DOI: https://doi.org/10.1007/BF02966399