Columnar cell hyperplasia of the breast

Last revised by Calum Worsley on 30 Nov 2021

Columnar cell hyperplasia is part of the spectrum of columnar cell lesions of the breast characterized by enlarged terminal ductal lobular units lined by stratified (more than two layers) columnar epithelium, cellular crowding or overlapping without atypia.

It can also form tufts or mounds with apical snouts. The columnar cells possess ovoid nuclei perpendicular to the basement membrane.


Along with columnar cell change, columnar cell hyperplasia has received many names such as columnar alterations of lobules, columnar metaplasia, columnar alteration with prominent apical snouts and secretions (CAPSS), blunt duct adenosis, enlarged lobular units with columnar alteration, hyperplastic enlarged lobular units and hyperplastic unfolded lobules.


Incidentally found on biopsy for mammographic clustered microcalcifications usually amorphous or fine pleomorphic.

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