Table 2
Differential diagnosis of sclerosing lesions
| Tubular carcinoma | Sclerosing adenosis | Microglandular adenosis | Radial scar |
| Infiltrative, often stellate architecture | Lobulocentric architecture | Infiltrative, disorderly architecture | Complex, stellate architecture |
| Desmoplastic stroma Central elastosis frequent |
Often central cellularity with sclerotic periphery |
Fibrotic stroma |
Variable stromal cellularity |
| Well formed, angulated tubules | Distorted, compressed tubules Frequent obliterated lumina |
Uniform, round tubules | Distorted tubules |
| Abundant eosinophilic cytoplasm, often with apical snouts | Infrequent apical snouts | Clear, vacuolated or granular epithelial cytoplasm. No apical snouts |
No apical snouts |
| Absent myoepithelial cells | Prominent admixed myoepithelial cells | Occasional myoepithelial cells described | Myoepithelial cells seen |
| Patchy, incomplete basement membrane | Uniform basement membrane | Prominent basement membrane | Basement membrane seen |
| Intraluminal secretion or microcalcification may be seen | Intraluminal microcalcification may be seen | Intraluminal colloid-like material which may be calcified | Intraluminal secretion uncommon. Microcalcification may be seen |
| Frequent associated low grade cribriform or micropapillary DCIS | May be associated apocrine metaplasia. Associated DCIS or lobular neoplasia are rare but described |
Atypical features rarely described (see text) | Associated cysts, sclerosing adenosis, epithelial hyperplasia and rarely in situ or invasive carcinoma |
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Reproduced with permission from Elston CW, Ellis IO
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