Breast Lesions, Tumors, Etc

Front 1

Diagnosis?

Back 1

Fibrocystic Change of the Breast:

Note the combination of mutiple benign changes-fibrosis, microcysts, adenosis

Front 2

Diagnosis?

Back 2

Cyst with apocrine change (Apocrine cyst)

How likely is this cyst to recur when compared to a simple cyst with cuboidal epithelium

Hint 2

More likely to recur.

Front 3

Diagnosis (2 synonomous names)

Back 3

Blunt duct adenosis or Columnar cell change

Name the histologic criteria:

Hint 3

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

This is a benign entity

Front 4

Diagnosis, please.

Back 4

Paget's disease of the nipple

What is the most common underlying malignancy in an affected breast?

Hint 4

Ductal carcinoma (sometimes DCIS!)

Front 5

What are Toker cells?

Back 5

Clear cells that can appear in the nipple and may be mistaken for Paget cells.

Front 6

What are helpful stains in differentiating Paget cells from Bowen disease and Melanoma?

Back 6

Bowen disease- Keratinocyte CK+, S100-, EMA-, Her2Neu-

Melanoma: melanin+, s100+, CK-

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

Front 7

Identify:

Back 7

Nipple Adenoma

Note the abrupt transition to the glandular tissue, distinct layers of myoep and epith tissue.

Front 8

A benign nipple lesion characterized by comma-shaped tubules

Back 8

Syringomatous adenoma of the nipple

Front 9

Identify:

Back 9

Apocrine metaplasia

Front 10

Identify:

Back 10

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?

Hint 10

Stains for the myoepithelial layer:

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