Surgical Pathology Criteria

Nodular Mucinosis of the Breast

Differential Diagnosis

A number of low grade or benign lesions are characterized by pools of mucin

Mucinous DCIS Extracellular, intralumenal mucin in a duct lined by DCIS, no mucin in contact with stroma
DCIS with mucocele-like lesion Typical DCIS with discrete areas of rupture resulting in mucin pools in stroma, no groups of cells floating in mucin
ADH with mucocele-like lesion Some but not all features required for diagnosis of DCIS with discrete areas of rupture resulting in mucin pools in stroma, no groups of cells floating in mucin
Mucocele-like lesion Pools of mucin in stroma variably lined by bland epithelium, usually no groups of cells floating in mucin (if present they are normal ductal cells and are not complex), almost always a microscopic lesion
Mucinous carcinoma Mucin in contact with stroma, neoplastic cells floating in mucin
Nodular mucinosis Nodules of stromal mucin, no epithelial component, subareolar
The mucin in all but nodular mucinosis should be strongly positive with the PAS and mucicarmine stains

 

 

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