Surgical Pathology Criteria

Collagenous Spherulosis

Differential Diagnosis

Adenoid Cystic Carcinoma Collagenous Spherulosis
Grossly visible or palpable lesion Nearly always an incidental microscopic finding
Invasive architecture Circumscribed, intraductal or intralobular
Uniform cores of basement membrane material Variable, frequently fibrillar spherules
Nuclei slightly enlarged compared to normal Nuclei identical in size and appearance to normal
CD117 positive lumenal cells CD117 negative
Calponin, smooth muscle myosin negative (even myoepithelial component) Calponin, smooth muscle myosin positive
Both contain myoepithelial and epithelial components

 

Cribriform Carcinoma Collagenous Spherulosis
Grossly visible or palpable lesion Nearly always an incidental microscopic finding
Invasive architecture Circumscribed, intraductal or intralobular
May have intralumenal mucin but lacks fibrillar or laminated appearance Frequently fibrillar or laminated spherules
Lacks myoepithelial component Myoepithelial cells surround spherules
Nuclei slightly enlarged compared to normal (2-3 times larger than RBC) Nuclei identical in size and appearance to normal

 

Cribriform Ductal Carcinoma In Situ Collagenous Spherulosis
May have intralumenal mucin but lacks fibrillar or laminated appearance Frequently fibrillar or laminated spherules
Myoepithelial component restricted to peripheral layer of duct Myoepithelial cells surround spherules
Nuclei slightly enlarged compared to normal (2-3 times larger than RBC) Nuclei identical in size and appearance to normal

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