Cytological diagnosis of collagenous spherulosis of breast

Collagenous spherulosis is a rare entity usually seen in association with benign breast lesions. It is often picked up incidentally with a reported incidence of about 0.2% in cytological material. There are very few reports describing cytomorphological features of collagenous spherulosis. To the best of our knowledge this is the only case reported from the middle-east region. The presence of hyaline spherules surrounded by a single layer of benign myoepithelial cells is the hallmark of collagenous spherulosis on FNA. However, due to close cytological resemblance, it can be misdiagnosed as adenoid cystic carcinoma of the breast. A 40-year-old woman presented with a history of a painless lump in the infraareolar region of left breast for a year. Fine needle aspiration was performed. The smears showed scanty cellularity comprising of cohesive clusters and a few branching fragments of benign ductal epithelial cells closely intermingled with many spherical, acellular homogenous hyaline globules. Few bare bipolar nuclei were noted in the background. A diagnosis of collagenous spherulosis associated with benign proliferative breast disease was made. Cytopathologists need to be aware of this entity in order to differentiate it from adenoid cystic carcinoma of the breast which requires radical treatment.