Lobular neoplasia Early lobular neoplasia, LIN1    (former ALH)   LIN3 (former LCIS) The newly established term “lobular neoplasia” refers to the entire spectrum of atypical epithelial proliferations originating in the terminal ducto-lobular unit. LN constitutes a risk factor for subsequent development of invasive carcinoma. For this reason, the classical term “lobular carcinoma in situ” (LCIS) has been considered as a misnomer. Histologically, the lobular architecture is maintained, but the acini are filled with monomorphic proliferation of loosely cohesive small cells,with uniform round nuclei and sparse cytoplasm. Mitoses are infrequent. By definition invasion is not alllwed, but pagetoid involvement of the terminal ducts (“lobular cancerisation”) is common. A three tiered grading system (LIN1, LIN2, LIN3) has been proposed, based on degree of proliferation and cytological features.

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