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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

Reproduced with permission from Elston CW, Ellis IO
Systemic Pathology 3rd Ed- The Breast. London: Churchill Livingstone, 1998.

  

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