Difference between revisions of "Atypical lobular hyperplasia"
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| Caption = Atypical lobular hyperplasia. [[H&E stain]]. (WC/Nephron) | | Caption = Atypical lobular hyperplasia. [[H&E stain]]. (WC/Nephron) | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = morphologic changes ('''a'''typia minimal - usually, '''b'''orders of cells distinct/visible - ''dyscohesive'', '''c'''lear cytoplasm (focal), '''d'''istend duct, '''e'''ccentric nucleus, usu. round, '''f'''illed ducts ('''no''' luminal spaces - '''key feature'''), limited extent (<50% of terminal duct lobular unit is involved) | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[lobular carcinoma in situ]], [[lobular carcinoma]] | | LMDDx = [[lobular carcinoma in situ]], [[lobular carcinoma]] | ||
| Line 40: | Line 40: | ||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
* | #Morphologic changes - memory device ''ABCDEF'': | ||
#*'''A'''typia minimal - usually. | |||
#**Relatively small ~1-2x size lymphocyte. | |||
#*'''B'''orders of cells distinct/visible - ''dyscohesive''. | |||
#*'''C'''lear cytoplasm (focal). | |||
#**May have a signet ring cell-like appearance. | |||
#*'''D'''istend duct. | |||
#*'''E'''ccentric nucleus, usu. round. | |||
#*'''F'''illed ducts. | |||
#**'''No''' luminal spaces - '''key feature'''. | |||
#***Partially filled ducts are ''not'' LCIS. | |||
#Limited extent: <50% of terminal duct lobular unit (TDLU) is involved. | |||
DDx: | DDx: | ||
Latest revision as of 05:14, 23 January 2017
| Atypical lobular hyperplasia | |
|---|---|
| Diagnosis in short | |
 Atypical lobular hyperplasia. H&E stain. (WC/Nephron) | |
|
| |
| LM | morphologic changes (atypia minimal - usually, borders of cells distinct/visible - dyscohesive, clear cytoplasm (focal), distend duct, eccentric nucleus, usu. round, filled ducts (no luminal spaces - key feature), limited extent (<50% of terminal duct lobular unit is involved) |
| LM DDx | lobular carcinoma in situ, lobular carcinoma |
| IHC | E-cadherin -ve |
| Site | breast |
|
| |
| Prognosis | benign |
Atypical lobular hyperplasia, abbreviated ALH, a pre-malignant change in the breast characterized by cellular proliferation and cellular dyscohesion.
It can be seen as the precursor to lobular carcinoma in situ, the precursor of lobular carcinoma.
General
- May occur with ductal involvement by cells of atypical lobular hyperplasia (abbreviated DIALH).[1]
- ALH with DIALH has a risk of developing breast cancer that is similar to LCIS.
Microscopic
Features:
- Morphologic changes - memory device ABCDEF:
- Atypia minimal - usually.
- Relatively small ~1-2x size lymphocyte.
- Borders of cells distinct/visible - dyscohesive.
- Clear cytoplasm (focal).
- May have a signet ring cell-like appearance.
- Distend duct.
- Eccentric nucleus, usu. round.
- Filled ducts.
- No luminal spaces - key feature.
- Partially filled ducts are not LCIS.
- No luminal spaces - key feature.
- Atypia minimal - usually.
- Limited extent: <50% of terminal duct lobular unit (TDLU) is involved.
DDx:
Images
ALH - low mag. (WC)
ALH - intermed. mag. (WC)
ALH - high mag. (WC)
ALH - E-cadherin - intermed. mag. (WC)
ALH - E-cadherin - high mag. (WC)
Benign breast - E-cadherin - intermed. mag. (WC)
Benign breast - E-cadherin - high mag. (WC)
Benign breast - E-cadherin - high mag. (WC)
IHC
- E-cadherin -ve or incomplete membrane staining.