Collagenous Spherulosis Associated with Lobular Carcinoma In Situ of the Breast: Two Case Reports

• Published in: Journal of pathology and translational medicine 2018, 52(6), , pp.420-424
• Main Authors: Kim, Ga-Eon, Kim, Nah Ihm, Lee, Ji Shin, Park, Min Ho
• Format: Article
• Language: English
• Subjects: Biopsy; Breast cancer; Brief Case Report; Case reports; Conflicts of interest; Medical screening; Ultrasonic imaging; 병리학
• ISSN: 2383-7837; 2383-7845
• DOI: 10.4132/jptm.2018.03.29

Collagenous spherulosis (CS) of the breast is an uncommon benign lesion, which is characterized by nodules of eosinophilic or basophilic basement membrane material enclosed in spherical spaces of cribriform architecture with myoepithelial and epithelial proliferation.1-4 While CS is usually encountered as an incidental finding in association with other benign hyperplastic lesions, the presence of calcification or abnormal density on imaging studies attracts clinical attention.24 CS is occasionally associated with lobular carcinoma in situ (LCIS).3-6 Despite its benign nature, the diagnosis of CS is challenging because it shows a cribriform architecture mimicking adenoid cystic carcinoma on low power.3,4,7,8 In addition, the diagnosis is especially difficult when associated with LCIS because it is often misdiagnosed as a cribriform pattern ductal carcinoma in situ (DCIS).3-8 Recently, it is predicted that the incidence of CS will increase due to breast cancer screening programs, and the pathologists need to be aware of CS in order not to misdiagnose CS associated with LCIS as DCIS or other malignancy, especially on core needle biopsy specimens. CASE REPORT The cases reported herein were consult cases, and this study was approved by the Institutional Review Board of Chonnam National University Hwasun Hospital with waiver of informed consents (CNUHH-EXP-2018-012). In challenging cases, immunohistochemical stains can facilitate differential diagnosis.4,7-10 Immunostaining for myoepithleial markers such as smooth muscle myosin heavy chain, p63, and calponin demonstrate the presence of a single layer of myoepithelial cells surrounding the spherules in CS. [...]breast cancer screening programs may detect increased numbers of CS cases with LCIS or CS alone.