Glycogen Rich Clear Cell Carcinoma of the Breast
Differential Diagnosis
- Lipid Rich Clear Cell Carcinoma
- Secretory Carcinoma
- Metastatic Renal Cell Carcinoma
- PEComa
- Eccrine Acrospiroma
- Adenomyoepithelioma
| Glycogen Rich Clear Cell Carcinoma | Lipid Rich Carcinoma |
|---|---|
| PAS positive, diastase sensitive glycogen | PAS negative |
| Lipid stain negative | Lipid stain positive |
| Clear cytoplasm | Cytoplasm clear to multivacuolated |
| Glycogen Rich Clear Cell Carcinoma | Secretory Carcinoma |
|---|---|
| PAS positive, diastase sensitive glycogen | PASd positive mucin |
| Cytology may be of any grade | Low grade cytology |
| No predilection for younger patients | Most cases <30 years |
| Behavior is that of usual invasive carcinoma | Excellent prognosis |
Metastatic Renal Cell Carcinoma
- RCC is favored by the following:
- Circumscribed mass lacking usual infiltrative pattern of breast carcinoma
- Some primary breast carcinomas are circumscribed
- Hemmorhage and prominent vascular pattern
- Circumscribed mass lacking usual infiltrative pattern of breast carcinoma
- Presence of an in situ component indicates a primary neoplasm
- History and imaging studies may be necessary
PEComa / Sugar Cell Tumor
- PEComa is keratin negative and HMB45 and smooth muscle actin positive
| Glycogen Rich Clear Cell Carcinoma | Eccrine Acrospiroma (Clear Cell Hidradenoma) |
|---|---|
| Intraparenchymal | Superficial |
| May have an intraductal component | No intraductal component |
| Single cell type | Two cell types |
| No squamous differentiation | Squamous eddies may be present |
| May have any degree of cytologic atypia | Low grade cytology |
| Glycogen Rich Clear Cell Carcinoma | Adenomyoepithelioma |
|---|---|
| Single cell type | Two cell types |
| No neoplastic myoepithelial cell component | Neoplastic myoepithelial component present |
| Clear cytoplasm in all areas | Clear cells confined to myoepithelial cells |
