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Table 1 Diagnostic criteria for columnar cell lesions used in the present study

From: Inter-observer variability between general pathologists and a specialist in breast pathology in the diagnosis of lobular neoplasia, columnar cell lesions, atypical ductal hyperplasia and ductal carcinoma in situ of the breast

  Columnar cell change Columnar cell hyperplasia Columnar cell change with atypia Columnar cell hyperplasia with atypia
  Flat epithelial atypia
Topography Terminal duct-lobular unit with variable dilation Terminal duct-lobular unit with variable dilation Terminal duct-lobular unit with variable dilation Terminal duct-lobular unit with variable dilation
Architecture 1 or 2 cell layers Cell stratification greater than 2 layers, complex cellular configurations are not present 1 or 2 cell layers Cellular stratification of more than 2 layers, complex cell configurations are not present
Cytology Columnar cells with ovoid to elongated nuclei orientated perpendicular to the basal membrane; nucleolus absent or inconspicuous. Columnar cells with ovoid to elongated nuclei orientated perpendicular to the basal membrane; “hobnail” cells might appear with absent or inconspicuous nuclei. Cytological atypia present (usually low-grade); the cells resemble tubular carcinoma. Mitoses are uncommon. Cytological atypia present (usually low-grade); the cells resemble tubular carcinoma. Mitoses are uncommon.
Apical decapitation Often present, not usually prominent. Often present, might be exaggerated. Often present, might be exaggerated. Often present, might be exaggerated.
Intraluminal secretions Might be present but are not usually prominent. Might be present and prominent. Might be present and prominent. Might be present and prominent.
Calcifications Might be present Usually present, might be psammomatous. Usually present, might be psammomatous. Usually present, might be psammomatous.
  1. Adapted from Schnitt and Vincent-Salomon[12], Fraser et al.[13], Tavassoli, & Devilee[11].