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    • Surgical Pathology Criteria
    http://surgpathcriteria.stanford.edu/

    Apocrine Adenosis of the Breast

    Definition

    • A haphazard proliferation of bland glands with apocrine differentiation

    Alternate/Historical Names

    • Adenomyoepithelial Adenosis
    • Secretory Adenosis

    Diagnostic Criteria

    • Variably sized open round glands
      • Eosinophilic granular secretion
    • Lumenal cells show apocrine differentiation
      • Tall columnar
      • Granular eosinophilic cytoplasm
      • Bland, basal nuclei
      • GCDFP15 positive
      • Occasional squamous metaplasia
    • Basal myoepithelial cells uniformly present
      • Flattened
      • Cytologically bland
      • Myoepithelial markers positive
    • Poorly circumscribed
      • Predominantly scattered through adipose tissue
      • Scant stroma
    • Most cases merge with adenomyoepithelioma

    Richard L Kempson MD
    Robert V Rouse MD
    Department of Pathology
    Stanford University School of Medicine
    Stanford CA 94305-5342

    Original posting:: May 15, 2006

    Supplemental studies

    Immunohistology

    • Lumenal cells
      • EMA, GCDFP15 positive
    • Basal cells
      • Positive for myoepithelial markers
        • Actin, calponin, p63
    • Basement membrane demonstrable with laminin stain

    Differential Diagnosis

     

    Sclerosing Adenosis with Apocrine Metaplasia Apocrine Adenosis
    Cellular, sclerotic stroma Stroma predominantly adipose
    Lobular Haphazard
    Small glands Variable, larger glands
    Compressed lumens Open lumens
    No association with adenomyoepithelioma Usually associated with adenomyoepithelioma

     

    Apocrine Adenosis Microglandular Adenosis
    Myoepithelial layer present, may be hyperplastic No myoepithelial cells
    Variable size and shape of glands Uniform round glands
    Apocrine lumenal differentiation and in some cases squamous metaplasia present No squamous or apocrine metaplasia
    EMA and GCDFP15 positive EMA and GCDFP15 negative

     

    Apocrine Adenosis Tubular Adenosis
    Variable but round glands Tubules
    Apocrine lumenal differentiation and in some cases squamous metaplasia present No squamous or apocrine metaplasia
    Frequently merges with adenomyoepithelioma No association with adenomyoepithelioma

     

    Apocrine Carcinoma Apocrine Adenosis
    Large vesicular nuclei with prominent nucleoli Small bland nuclei
    No myoepithelial layer Myoepithelial layer present

    Clinical

    • Benign lesion

    Grading / Staging / Report

    • Grading and staging are not applicable

    Lists

    Adenosis of the Breast

    Breast Tumors and Lesions Exhibiting Reactivity for Muscle/Myoepithelial Markers

    (Most benign lesions with an epithelial component will have a myoepithelial cell layer)

    Bibliography

    • Eusebi V, Foschini MP, Betts CM, Gherardi G, Millis RR, Bussolati G, Azzopardi JG. Microglandular adenosis, apocrine adenosis, and tubular carcinoma of the breast. An immunohistochemical comparison. Am J Surg Pathol. 1993 Feb;17(2):99-109.
    • Eusebi V, Casadei GP, Bussolati G, Azzopardi JG. Adenomyoepithelioma of the breast with a distinctive type of apocrine adenosis. Histopathology. 1987 Mar;11(3):305-15.
    • Diaz NM, McDivitt RW, Wick MR. Microglandular adenosis of the breast. An immunohistochemical comparison with tubular carcinoma. Arch Pathol Lab Med. 1991 Jun;115(6):578-82.
    • Tavassoli FA, Bratthauer GL. Immunohistochemical profile and differential diagnosis of microglandular adenosis. Mod Pathol. 1993 May;6(3):318-22.
    • Kiaer H. Adenomyoepithelial adenosis. Am J Surg Pathol. 1987 Mar;11(3):235.
    • Kiaer H, Nielsen B, Paulsen S, Sorensen IM, Dyreborg U, Blichert-Toft M. Adenomyoepithelial adenosis and low-grade malignant adenomyoepithelioma of the breast. Virchows Arch A Pathol Anat Histopathol. 1984;405(1):55-67.
    Printed from Surgical Pathology Criteria: http://surgpathcriteria.stanford.edu/
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