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10 Cards in this Set

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Diagnosis?
Fibrocystic Change of the Breast:

Note the combination of mutiple benign changes-fibrosis, microcysts, adenosis
Diagnosis?
Cyst with apocrine change (Apocrine cyst)

How likely is this cyst to recur when compared to a simple cyst with cuboidal epithelium
More likely to recur.
Diagnosis (2 synonomous names)
Blunt duct adenosis or Columnar cell change

Name the histologic criteria:
luminal epith replaced by columnar cells with snouts. The ducts take on a more complicated pattern with branching, etc.

This is a benign entity
Diagnosis, please.
Paget's disease of the nipple

What is the most common underlying malignancy in an affected breast?
Ductal carcinoma (sometimes DCIS!)
What are Toker cells?
Clear cells that can appear in the nipple and may be mistaken for Paget cells.
What are helpful stains in differentiating Paget cells from Bowen disease and Melanoma?
Bowen disease- Keratinocyte CK+, S100-, EMA-, Her2Neu-

Melanoma: melanin+, s100+, CK-

Paget: Melanin +/-, CEA +, keratinocyte CK -, S100 +/-, H2Neu +
Identify:
Nipple Adenoma

Note the abrupt transition to the glandular tissue, distinct layers of myoep and epith tissue.
A benign nipple lesion characterized by comma-shaped tubules
Syringomatous adenoma of the nipple
Identify:
Apocrine metaplasia
Identify:
Sclerosing Adenosis

Note the compression of the glands by the stroma but overall retention of the lobular structure and double-layered glands.

What IHC can help you distinguish this from malignancy?
Stains for the myoepithelial layer:

HMWK (CK5/6), SMA, Calponin, smooth muscle myosin heavy chain, p63