Surgical Pathology Criteria

Histiocytoid Carcinoma of the Breast

Differential Diagnosis

 

Lipid Rich Carcinoma Histiocytoid Carcinoma
Lipid stain positive Lipid stain negative
GCDFP15 variable to weak GCDFP15 strong positive
Mucin negative Mucin positive intracytoplasmic lumens or granular cytoplasm
May have any grade cytology Low grade cytology
Lacks intracytoplasmic lumens May have intracytoplasmic lumens

 

Glycogen Rich Clear Cell Carcinoma Histiocytoid Carcinoma
Clear cytoplasm Finely vacuolated cytoplasm
PAS shows abundant glycogen PAS shows granular mucin
GCDFP15 variable GCDFP15 strong positive

 

Histiocytoid Carcinoma Secretory Carcinoma
All reported cases >40 years Most cases <30 years
Scant or granular mucin Abundant cytoplasmic mucin
GCDFP15 strong positive GCDFP15 variable
Aggressive behavior Excellent prognosis

 

Histiocytoid Carcinoma Granular Cell Tumor
Keratin, EMA positive Keratin, EMA negative
GCDFP15 positive GCDFP15 negative
S100 negative or trace S100 positive

 

Histiocytoid Carcinoma Fat Necrosis, Inflammation, Histiocytic Infiltrations
Keratin, EMA positive Keratin, EMA negative
GCDFP15 positive GCDFP15 negative
CD68, HAM56 negative CD68, HAM56 positive
Low grade atypia Completely bland nuclei
Granular mucin positivity Mucin stains negative

 

Histiocytoid Carcinoma Apocrine Carcinoma of the Breast
Amphophilic to weakly eosinophilic cytoplasm Intensely eosinophlic cytoplasm
Cytoplasm vacuolated, occasionally granular Cytoplasm granular
Indistince cytoplasmic borders Sharp cytoplasmic borders
Small nuclei and nucleoli Large vesicular nuclei with prominent nucleoli
Appears to have more aggressive behavior than usual carcinoma Appears to have better behavior than usual carcinoma in some series
Some consider histiocytoid carcinoma to be a variant of breast carcinomas with apocrine features

 

Is Histiocytoid Carcinoma a variant of Lobular Carcinoma?

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