Surgical Pathology Criteria–

Lipid Rich Carcinoma of the Breast

Differential Diagnosis

 

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

 

Lipid Rich Carcinoma Secretory Carcinoma
Scant PASd positivity in cells Abundant PASd positive mucin
Fat stains positive Fat stains negative
May have any grade cytology Low grade cytology
No predilection for young patients Most cases <30 years
Many show aggressive behavior Excellent prognosis

 

Lipid Rich Carcinoma Apocrine Carcinoma
Cytoplasm clear to multivacuolated Cytoplasm nearly uniformly granular
Cytoplasm at most focally eosinophilic Cytoplasm nearly uniformly eosinophilic
Scant PASd positivity in cells Frequently PASd positive
Fat stains positive Fat stains negative
GCDFP15 variable/weak GCDFP15 strong positive

 

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

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