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  • Surgical Pathology Criteria
    http://surgpathcriteria.stanford.edu/

    Tubular Adenosis of the Breast

    Definition

    • Benign haphazard proliferation of elongated tubules

    Diagnostic Criteria

    • Elongated tubules
      • Occasional branching
      • May have thick basement membrane
    • Lumens variable
      • Collapsed to dilated
      • No apical snouts
      • Lumenal eosinophilic colloid-like or basophilic secretion
        • Focal lumenal calcification
    • Cytologically bland
      • Small indististinct nucleoli
      • MItotic figures uncommon
    • Haphazard distribution
      • Poorly circumscribed
      • At most vague lobular grouping
      • Not crowded
      • May infiltrate fat
    • Background of fibrous or fatty tissue
      • Generally hypocellular, may be focally cellular
    • Myoepithelial layer present

      Richard L Kempson MD
      Robert V Rouse MD
      Department of Pathology
      Stanford University School of Medicine
      Stanford CA 94305-5342

      Original posting: May 27, 2006

    Supplemental studies

    Immunohistology

    • Myoepithelial layer present
      • Actin and S100 positive
      • Not reported but p60 and calponin expected to be positive

    Differential Diagnosis

    Tubular Carcinoma Tubular Adenosis
    Stellate, infiltrating Diffuse
    Frequent apical snouts No apical snouts
    Ducts with frequent pointed ends Infrequent pointed ends
    Empty lumens Eosinophilic secretion present in at least some lumens
    Stroma desmoplastic Stroma usually hypocellular or fat
    No myoepithelial cells Myoepithelial cells

    Microglandular Adenosis Tubular Adenosis
    Uniformly round lumens Predominantly tubular
    Cytoplasm frequently clear Cytoplasm eosinophilic
    No myoepithelial layer Myoepithelial cells present
    Secretion eosinophilic Secretion eosinophilic or basophilic

    Apocrine Adenosis Tubular Adenosis
    Variable but round glands Tubules
    Apocrine lumenal differentiation and in some cases squamous metaplasia present No squamous or apocrine metaplasia
    Frequently merges with adenomyoepithelioma No association with adenomyoepithelioma

    Sclerosing Adenosis Tubular Adenosis
    Lobular architecture Haphazard
    Crowded glands Dispersed
    Most lumens compressed Lumens vary from compressed to dilated

    Tubular Adenosis Tubular Adenoma
    Diffuse, infiltrative Circumscribed
    Surrounds normal elements Mass displaces normal elements
    Haphazardly scattered tubules Densely packed tubules
    Abundant fibrous or fatty stroma Scant stroma
    These are similar in name only

    Clinical

    • Age 40-82 years
    • 5 of 6 reported cases associated with DCIS
      • Cancerization of lesion or elsewhere in breast
    • No recurrence of tubular adenosis
    • Size 0.5-3 cm

    Lists

    Adenosis of the Breast

    Bibliography

    • Lee KC, Chan JK, Gwi E. Tubular adenosis of the breast. A distinctive benign lesion mimicking invasive carcinoma. Am J Surg Pathol. 1996 Jan;20(1):46-54.
    Printed from Surgical Pathology Criteria: http://surgpathcriteria.stanford.edu/
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