Atypical Lobular Hyperplasia of the Breast
Supplemental Studies
Immunohistology
- E-cadherin is typically negative in normal and neoplastic lobular cells
- It appears to be a sensitive marker of ductal differentiation vs lobular differentiation; but its utility in borderline lesions is currently uncertain
- In pagetoid spread of LCIS or ALH into ducts, an E-caherin negative population will be seen disrupting the positively stained normal ductal cells
- Cytokeratin 8 (detected by CAM5.2) may stain both ductal and lobular processes but accentuates the discohesive pattern in LCIS and ALH ("bag of marbles")