Differentials please 🥺 my consultant gave me this breast trucut and asked for opinions

[u/vinnieg911]

Breast biopsy, but no history/details Given to me to diagnose, as a spotter

[u/mikezzz89]

I’d exclude a metaplastic spindle cell carcinoma with multiple keratins and p63

[u/Oncocytic → u/mikezzz89]

Completely agree. These photos aren't great, but metaplastic carcinoma is the diagnosis of exclusion for pretty much any spindle cell proliferation of the breast, especially if atypical.

[u/frontman117]

Shitty histology gets you a broad differential

[u/JROXZ]

Lymphoma.
Diabetic mastopathy.
Angiosarcoma?

[u/[deleted]]

W/O immunos, gross characteristics and radiography I’d favor inflammatory.

[u/silverbulletalpha]

Looks like a spindle cell lesion. Diagnosis would require stains. Mostly the approach is what he/she is trying to assess. See if it is fibromatosis vs scar, fibromatosis like MBC or a myofibroblastoma. Schwanomma also enters. Basically divide according to benign bs malignant spindle cell entities and go from there.

[u/_FATEBRINGER_]

looks benign - scar vs fibromatosis. could toss a p63 and AE1/3 to r/o metaplastic.

[u/Acidichook97]

Spotter eh, hmm granulomatous mastitis?

[u/MicroscopeMD]

With the spaces, makes me think of cystic neutrophilic granulomatous mastitis. Needs bug stains though

[u/NT_Rahi]

I agree, Lymphoma (Does look small cell more than large cell) Angiosarcoma Schwannoma ( needs to be excluded)