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Diminished number or complete loss of myoepithelial cells associated with metaplastic and neoplastic apocrine lesions of the breast.
- Source :
-
The American journal of surgical pathology [Am J Surg Pathol] 2011 Feb; Vol. 35 (2), pp. 202-11. - Publication Year :
- 2011
-
Abstract
- The presence of myoepithelial (ME) cells is considered an important feature in the vast majority of benign breast lesions. Recently, a case showing the absence of myoepithelium in a mammary duct with apocrine metaplasia was reported. To investigate the status of ME cells associated with apocrine metaplasia, the distribution of ME cells in 59 metaplastic and intraductal proliferative apocrine lesions was evaluated using immunohistochemical expression of p63 and Calponin. p63 showed a diminished number of ME cells and increased intermyoepithelial nuclear distance in ducts with all variants of apocrine metaplasia and proliferation compared with normal glands. In the majority of cases, Calponin showed a continuous ME layer. In 6 cases, including an apocrine papilloma, there were definitive ME gaps confirmed by both markers, in the absence of atypia and with preservation of the basement membrane. In all cases, there was frequent heterogeneity in the distribution of ME cells in ducts harboring apocrine cells and even in various papillae within papillary lesions. In summary, benign and noninvasive apocrine lesions can show reduction and occasional complete loss of ME cells. This observation is particularly important when evaluating apocrine papillary proliferations, in which the absence of ME cells may lead to overdiagnosis of atypia and/or malignancy. The observation suggests that at least 2 ME markers should be used when evaluating apocrine lesions, and that a malignant diagnosis should be based on features of the proliferating cells until more data become available on the significance, if any, of the absence of ME cells in apocrine lesions.
- Subjects :
- Adenoma, Sweat Gland metabolism
Adenoma, Sweat Gland surgery
Adult
Aged
Aged, 80 and over
Apocrine Glands metabolism
Biomarkers, Tumor metabolism
Breast Neoplasms metabolism
Breast Neoplasms surgery
Calcium-Binding Proteins metabolism
Carcinoma, Intraductal, Noninfiltrating metabolism
Carcinoma, Intraductal, Noninfiltrating surgery
Cell Proliferation
Epithelial Cells metabolism
Female
Humans
Hyperplasia
Immunohistochemistry
Mastectomy
Membrane Proteins metabolism
Metaplasia
Microfilament Proteins metabolism
Middle Aged
Myocytes, Smooth Muscle metabolism
Neoplasms, Multiple Primary
Sweat Gland Neoplasms metabolism
Sweat Gland Neoplasms surgery
Calponins
Adenoma, Sweat Gland pathology
Apocrine Glands pathology
Breast Neoplasms pathology
Carcinoma, Intraductal, Noninfiltrating pathology
Epithelial Cells pathology
Myocytes, Smooth Muscle pathology
Sweat Gland Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-0979
- Volume :
- 35
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The American journal of surgical pathology
- Publication Type :
- Academic Journal
- Accession number :
- 21263240
- Full Text :
- https://doi.org/10.1097/PAS.0b013e31820598a2