The mucinous variant of columnar cell lesions

Histopathology. 2011 May;58(6):847-53. doi: 10.1111/j.1365-2559.2011.03837.x.

Abstract

Aims: Mucin-producing columnar cell lesions (CCL) are a rare, new entity in the breast. The aim of this study was to describe the incidence and follow-up of mucinous CCLs.

Methods and results: Of 4164 breast core needle biopsies (CNBs), 291 showed a CCL and 21 atypical ductal hyperplasia (ADH) originating in a CCL (ADH-CCL). Mucin production was present in 17 of 291 (5.8%) CCLs and three of 21 (14.3%) ADH-CCLs, together concerning 0.5% of all CNBs. The most common mucinous CCL pattern was a columnar cell change without atypia, and almost all were detected with microcalcifications as an abnormality at mammography. During a median follow-up of 3.1 years, no invasive carcinoma or ductal carcinoma in situ was detected. MUC2 was expressed in intraluminal mucin in 12 of 15 (80%) mucinous CCLs, and showed cytoplasmic expression in five of 15 (33%) mucinous CCLs seen in CNBs. Moreover, mucinous CCLs were significantly more common in association with 46 mucinous carcinomas than in 46 ductal carcinomas (28% versus 9%).

Conclusions: Mucinous CCLs are rare lesions, with an incidence of about 0.5% in breast CNBs, usually presenting with microcalcifications. Although these lesions might play a role in the mucinous progression spectrum, the short-term risk of progression to more advanced lesions seems to be low.

MeSH terms

  • Adenocarcinoma, Mucinous / diagnosis
  • Adenocarcinoma, Mucinous / metabolism*
  • Adenocarcinoma, Mucinous / pathology*
  • Adult
  • Aged
  • Biopsy, Needle
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / metabolism*
  • Breast Neoplasms / pathology*
  • Carcinoma, Intraductal, Noninfiltrating / diagnosis
  • Carcinoma, Intraductal, Noninfiltrating / metabolism
  • Carcinoma, Intraductal, Noninfiltrating / pathology
  • Carcinoma, Papillary / diagnosis
  • Carcinoma, Papillary / metabolism
  • Carcinoma, Papillary / pathology
  • Cell Shape*
  • Diagnosis, Differential
  • Disease Progression
  • Female
  • Humans
  • Hyperplasia / diagnosis
  • Hyperplasia / metabolism
  • Hyperplasia / pathology
  • Middle Aged
  • Mucin-2 / metabolism*
  • Retrospective Studies

Substances

  • MUC2 protein, human
  • Mucin-2