Columnar Cell Change and Columnar Cell Hyperplasia of the Breast
Definition
- Breast lesions characterized by a variably proliferative, cytologically bland columnar epithelium, lining dilated terminal duct-lobular units, often with luminal secretions and cytoplasmic blebs on the lining cells
Alternate/Historical Names
- Columnar alteration with prominent apical snouts and secretions (CAPSS) without atypia
- Columnar alterations of lobules
- Columnar metaplasia
- Pretubular hyperplasia
Diagnostic Criteria
- Columnar cell change
- Involves dilated terminal duct-lobular units
- Lined by uniform, ovoid-to-elongate, non-atypical columnar cells
- One or two cell layers thick
- Chromatin evenly dispersed
- Inconspicuous nucleoli
- Columnar cell hyperplasia
- Involves dilated terminal duct-lobular units
- Lined by columnar cells identical to those seen in columnar cell change
- Lining greater than two cells thick
- May form small mounds, tufts and micropapillations
- Architectural complexity must be short of that seen in low grade ductal carcinoma in situ
- No partial or complete filling of ducts
- Arcades, microacini and micropapillary formations absent or very rare
- Both frequently exhibit prominent apical snouts
- Flat epithelial atypia (similar lesion but with nuclear atypia) is considered separately
Kristin C Jensen MD
Richard L Kempson MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting:: January 16, 2007
