Surgical Pathology Criteria

Columnar Cell Change and Columnar Cell Hyperplasia of the Breast

Differential Diagnosis


Flat Epithelial Atypia Columnar Cell Change / Hyperplasia
Enlarged atypical ovoid to round nuclei Bland oval to elongate nuclei
Chromatin may be marginated Bland chromatin
Nucleoli may be prominent Nucleoli not prominent
Basal polarization of nuclei usually lacking Nuclei usually basally polarized
Frequently more abundant cytoplasm Moderate amount of cytoplasm


Low Grade Ductal Carcinoma In Situ and Atypical Ductal Hyperplasia Columnar Cell Change / Hyperplasia
Architectural complexity manifested by a) partial or complete filling of ducts or b) arcades or micropapillary formations Essentially a flat lesion, lacks architectural complexity
Low grade nuclear atypia present (except some cases of ADH that have architectural complexity) Cytologically bland


Apocrine Metaplasia Columnar Cell Change / Hyperplasia
Cuboidal with voluminous eosinophilic cytoplasm Lacks architectural complexity
Frequent prominent nucleoli Bland oval nuclei


Fibrocystic Change vs Columnar Cell Change / Hyperplasia

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