Virchows Archiv

, Volume 471, Issue 1, pp 3–12 | Cite as

Invasive lobular carcinoma with extracellular mucin production—a novel pattern of lobular carcinomas of the breast. Clinico-pathological description of eight cases

  • Gábor Cserni
  • Giuseppe Floris
  • Nektarios Koufopoulos
  • Anikó Kovács
  • Afroditi Nonni
  • Peter Regitnig
  • Anders Stahls
  • Zsuzsanna Varga
Original Article

Abstract

Invasive lobular carcinoma of the breast is known to produce intracellular mucin and has been recognized in single-case reports to show extracellular mucin production, as well. This latter morphology is not only rare but must also be under- or misdiagnosed. The aim was to better characterize this entity. Cases of lobular cancers demonstrating extracellular mucin formation were identified in a multi-institutional effort and their clinical and morphologic features were assessed. Immunohistochemistry was used to characterize the E-cadherin-membrane complex, neuroendocrine differentiation, and to some extent, mucin formation. All but one of the eight cases occurred in postmenopausal patients. Extracellular mucin production was present in 5 to 50% of the tumour samples and rarely also appeared in nodal and distant metastases. The tumours were completely E-cadherin negative and showed cytoplasmic p120 positivity. The majority (n = 6/8) was also completely negative for β-catenin, but two tumours displayed focal β-catenin positivity in the mucinous area. MUC1 and MUC2 expression was observed in all and 7/8 tumours, respectively; neuroendocrine differentiation was present in only one. Invasive lobular carcinoma with extracellular mucin formation is a rare morphologic variant of lobular carcinoma prone to be misdiagnosed and warranting further studies.

Keywords

Breast cancer E-cadherin Extracellular mucin Lobular carcinoma Mucinous carcinoma 

Notes

Acknowledgements

The authors thank the help of Drs. Susanne Zöch and Sigurd Lax (Landeskrankenhaus Graz Süd-West, Graz, Austria); Dr. Vasiliki Zolota (University of Patras, Greece); Dr. Georgia Kafiri (Hippokrateio Hospital of Athens, Greece); Dr. Paivi Heikkila (University of Helsinki, Finland); Drs. Celia Perdaens and Veerle Delvaux (Jan Portaels Hospital, Vilvvorde, Belgium); and Dr. Janina Kulka (Semmelweis University, Budapest, Hungary) for their help in collecting the cases and or relevant clinical details. This study was partially funded by the National Research, Development and Innovation Office grant GINOP-2.3.2-15-2016-00020.

Author Contributions

All authors of the manuscript made substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work; and drafting the work and/or revising it critically for important intellectual content; and final approval of the version submitted for publication and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Other contribution is acknowledged in the Acknowledgements section of the manuscript.

Compliance with ethical standards

The authors have consulted the journal policy regarding compliance with ethical standards and state that accepted principles of ethical and professional conduct have been followed. The authors include information regarding sources of funding and potential conflicts of interest (financial or non-financial). Ethical approval and informed consent related information (waiver for this particular study) are summarized in the final paragraph of the “Material and Methods”. The study did not include animals, therefore issues relating to animal welfare do not apply.

Funding

This study was partially funded by the National Research, Development and Innovation Office grant GINOP-2.3.2-15-2016-00020.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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ESM 1 (PDF 8225 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of PathologyBács-Kiskun County Teaching HospitalKecskemétHungary
  2. 2.Department of PathologyUniversity of SzegedSzegedHungary
  3. 3.Department of Imaging and Pathology, Laboratory of Translational Cell and Tissue ResearchKU Leuven-University of LeuvenLeuvenBelgium
  4. 4.Department of PathologyKU Leuven-University of Leuven, University Hospitals Leuven LeuvenBelgium
  5. 5.Department of Pathology“Saint Savvas” Anticancer Hospital of AthensAthensGreece
  6. 6.Department of Clinical Pathology and GeneticsSahlgrenska University HospitalGothenburgSweden
  7. 7.First Department of Pathology, Medical SchoolNational and Kapodistrian University of AthensAthensGreece
  8. 8.Institute of PathologyMedical University of GrazGrazAustria
  9. 9.Department of PathologyUniversity of Helsinki and HUSLAB, Helsinki University HospitalHelsinkiFinland
  10. 10.Department of Pathology and Molecular PathologyUniversity Hospital ZurichZürichSwitzerland

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