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18 Cards in this Set
- Front
- Back
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"lumpy bumpy" breast on palpation
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fibrocystic breast (nonproliferative)
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A woman presents with a solitary, firm, palpable mass. The physician decides to perform a fine needle biopsy. After, the FNA biopsy, the mass disappears. What was the most likely cause of the symptoms?
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A non-proliferative cyst
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List the three patterns of morphologic changes associated with nonproliferative breast changes.
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Cyst, fribrosis, adenosis
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What is adenosis?
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defined as an increase in the number of acini per lobule. A normal physiologic adenosis occurs during pregnancy throughout the breast. In nonpregnant women, adenosis can occur as a focal change. Calcifications are occasionally present within the lumens.
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How is adenosis associated with fibrocystic changes different from sclerosing adenosis?
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In adenosis associated with nonproliferative (fibrocystic) changes the acini are enlarged (like sclerosing adenosis) but are not distorted as is seen in sclerosing adenosis.
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Describe the morphology of apocrine cysts.
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cells with round nuclei and abundant granular eosinophilic cytoplasm, resembling the cells of normal apocrine sweat glands. Secretory debris, frequent with calcifications is often present.
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What morphologic change contributes to the palpable firmness of the breast associated with nonproliferative changes.
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Fibrosis. Cysts frequently rupture, with release of secretory material into the adjacent stroma. The resulting chronic inflammation and fibrous scarring contribute to the palpable firmness of the breast.
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"blue-dome" cysts.
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Unopened cysts that are brown to blue owing to the contained semitranslucent, turbid fluid.
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The most common presentation of large duct papillomas.
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nipple discharge (80%)
the remainder present as small palpable masses or mammographic densities. |
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Most common clinical presentation of proliferative breast disease without atypia is palpable mass.T/F?
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FALSE
proliferative breast disease without atypia rarely forms palpable mass. The changes are more commonly detected as mammographic densities or calcifications. |
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Most likely cause of bloody discharge in a proliferative breast without atypia?
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Infarction of a large duct papilloma (due to torsion of the stalk)
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Match the morphology with the type of proliferative breast disease without atypia.
1) stellate lesions characterized by a central nidus of entrapped glands in a hyalined stroma 2) irregular slit like fenestrations at the periphery of the cellular masses. 3) Increased number of acini that are compressed and distorted in the central portion of the lesion but are dilated at the periphery. 4) multiple branching fibrovascular cores, each having a connective tissue axis lined by luminal and myoepithelial cells. |
1) complex sclerosing lesion (radial scar)
2) epithelial hyperplasia 3) sclerosing adenosis 4) papillomas |
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The difference between small duct and large papillomas.
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Large duct papillomas are usually solitary and situated in the lactiferous sinuses of the nipple. Small duct papillomas are commonly multiple and located deeper within the ductal system.
Small duct carcinoma increase the risk of subsequent carcinoma. It is less clear whether or nor large duct papillomas carry the same risk. |
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On occasion, stromal fibrosis in sclerosing adenosis may completely compress the lumens to create the appearance of solid cords or double strands of cells lying within dense stroma, a histologic pattern that closely mimics the appearance of invasive carcinoma. How can you distinguish the two lesions?
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Unlike carcinomas, the acini are arranged in a swirling pattern and the outer border is usually well circumscribed.
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Two types of proliferative breast disease with atypia?
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ADH and ALH
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How is ADH different from ductal carcinoma in situ?
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ADH is recognized by its histologic resemblance to ductal carcinoma in situ, including a monomorphic cell population, regular cell placement, and round lumina. However, the lesions are characteristically limited in extent, and the cells are not completely monomorphic in type or they fail to completely fill ductal spaces.
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How is ALH different from LCIS?
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the cells in ALH do not fill or distend more than 50% of the acini within a lobule.
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ALH can extend into ducts, and this finding is associated with an increased risk of developing invasive carcinoma. T/F?
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TRUE.
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