The mucinous variant of columnar cell lesions

• Published in: Histopathology 2011-05, Vol.58 (6), p.847-853
• Main Authors: Verschuur-Maes, Anoek H J, Van Diest, Paul J
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Mucinous - diagnosis; Adenocarcinoma, Mucinous - metabolism; Adenocarcinoma, Mucinous - pathology; Adult; Aged; Biological and medical sciences; Biopsy, Needle; breast; Breast Neoplasms - diagnosis; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Carcinoma, Intraductal, Noninfiltrating - diagnosis; Carcinoma, Intraductal, Noninfiltrating - metabolism; Carcinoma, Intraductal, Noninfiltrating - pathology; Carcinoma, Papillary - diagnosis; Carcinoma, Papillary - metabolism; Carcinoma, Papillary - pathology; Cell Shape; columnar cell lesions; core needle biopsy; Diagnosis, Differential; Disease Progression; Female; flat epithelial atypia; Humans; Hyperplasia - diagnosis; Hyperplasia - metabolism; Hyperplasia - pathology; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Middle Aged; Mucin-2 - metabolism; mucinous; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Retrospective Studies
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/j.1365-2559.2011.03837.x

Verschuur‐Maes A H J & Van Diest P J
(2011) Histopathology 58, 847–853
The mucinous variant of columnar cell lesions Aims:  Mucin‐producing columnar cell lesions (CCL) are a rare, new entity in the breast. The aim of this study was to describe the incidence and follow‐up of mucinous CCLs. Methods and results:  Of 4164 breast core needle biopsies (CNBs), 291 showed a CCL and 21 atypical ductal hyperplasia (ADH) originating in a CCL (ADH‐CCL). Mucin production was present in 17 of 291 (5.8%) CCLs and three of 21 (14.3%) ADH‐CCLs, together concerning 0.5% of all CNBs. The most common mucinous CCL pattern was a columnar cell change without atypia, and almost all were detected with microcalcifications as an abnormality at mammography. During a median follow‐up of 3.1 years, no invasive carcinoma or ductal carcinoma in situ was detected. MUC2 was expressed in intraluminal mucin in 12 of 15 (80%) mucinous CCLs, and showed cytoplasmic expression in five of 15 (33%) mucinous CCLs seen in CNBs. Moreover, mucinous CCLs were significantly more common in association with 46 mucinous carcinomas than in 46 ductal carcinomas (28% versus 9%). Conclusions:  Mucinous CCLs are rare lesions, with an incidence of about 0.5% in breast CNBs, usually presenting with microcalcifications. Although these lesions might play a role in the mucinous progression spectrum, the short‐term risk of progression to more advanced lesions seems to be low.