Difference between revisions of "Nipple adenoma"

From Libre Pathology
Jump to navigation Jump to search
 
(6 intermediate revisions by 2 users not shown)
Line 7: Line 7:
| Micro      = proliferation of epithelial and myoepithelial elements that extends into the breast stroma; not encapsulated; lacks true fibrovascular cores, +/-focal necrosis
| Micro      = proliferation of epithelial and myoepithelial elements that extends into the breast stroma; not encapsulated; lacks true fibrovascular cores, +/-focal necrosis
| Subtypes  =
| Subtypes  =
| LMDDx      = [[intraductal papilloma]]
| LMDDx      = [[intraductal papilloma of the breast]]
| Stains    =
| Stains    =
| IHC        =
| IHC        =
Line 35: Line 35:


==General==
==General==
*Rare.<ref><{{Cite journal  | last1 = Shinn | first1 = L. | last2 = Woodward | first2 = C. | last3 = Boddu | first3 = S. | last4 = Jha | first4 = P. | last5 = Fouroutan | first5 = H. | last6 = Péley | first6 = G. | title = Nipple adenoma arising in a supernumerary mammary gland: a case report. | journal = Tumori | volume = 97 | issue = 6 | pages = 812-4 | month =  | year =  | doi = 10.1700/1018.11102 | PMID = 22322852 }}/ref>
*A benign lesion with papillary architecture arising at the nipple. 
*Rare.<ref>{{Cite journal  | last1 = Shinn | first1 = L. | last2 = Woodward | first2 = C. | last3 = Boddu | first3 = S. | last4 = Jha | first4 = P. | last5 = Fouroutan | first5 = H. | last6 = Péley | first6 = G. | title = Nipple adenoma arising in a supernumerary mammary gland: a case report. | journal = Tumori | volume = 97 | issue = 6 | pages = 812-4 | month =  | year =  | doi = 10.1700/1018.11102 | PMID = 22322852 }}</ref>
*Reported in men.<ref name=pmid22342578/>
*Reported in men.<ref name=pmid22342578/>


Line 43: Line 44:
==Microscopic==
==Microscopic==
Features:
Features:
*Not encapsulated.<ref name=pmid2123505/>
*Proliferation of epithelial and myoepithelial elements that extends into the breast stroma.<ref name=pmid2123505>{{Cite journal  | title = Adenoma of Nipple. | journal = Br Med J | volume = 1 | issue = 5330 | pages = 563 | month = Mar | year = 1963 | doi =  | PMID = 20789667 | PMC = 2123505 | url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2123505/?page=1 }}</ref>
*Proliferation of epithelial and myoepithelial elements that extends into the breast stroma.<ref name=pmid2123505>{{Cite journal  | title = Adenoma of Nipple. | journal = Br Med J | volume = 1 | issue = 5330 | pages = 563 | month = Mar | year = 1963 | doi =  | PMID = 20789667 | PMC = 2123505 | url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2123505/?page=1 }}</ref>
*Arborising papillomatous epithelial proliferation within duct
*(Papillae have fibrovascular cores) at least as far as I can see but not according to Stanford. 
*Florid epithelial hyperplasia can be seen
*Can see haphazard arrangement of proliferating tubular structures


Notes:
Notes:
*Not encapsulated.<ref name=pmid2123505/>
*Lacks true fibrovascular cores.<ref>URL: [http://surgpathcriteria.stanford.edu/breast/nippleadenoma/printable.html http://surgpathcriteria.stanford.edu/breast/nippleadenoma/printable.html]. Accessed on: 6 August 2011.</ref>
*Lacks true fibrovascular cores.<ref>URL: [http://surgpathcriteria.stanford.edu/breast/nippleadenoma/printable.html http://surgpathcriteria.stanford.edu/breast/nippleadenoma/printable.html]. Accessed on: 6 August 2011.</ref>
*Focal necrosis may be present.<ref name=Ref_APBR307>{{Ref APBR|307 Q16}}</ref>
*Focal necrosis may be present.<ref name=Ref_APBR307>{{Ref APBR|307 Q16}}</ref>


DDx:
DDx:
*[[Intraductal papilloma]].
*[[Intraductal papilloma of the breast]].
**Found within the duct '''not''' the stroma.
**Found within the duct '''not''' the stroma.
**Often deeper - one should '''not''' see skin in the histologic section.
**Often deeper - one should '''not''' see skin in the histologic section.
*Syringomatous adenoma
*Intraductal carcinoma - the proliferation in nipple adenoma should be no more atypical than that seen with usual intraductal hyperplasia or intraductal papillomatosis.  Cribriforming glands should be absent
*Invasive ductal carcinoma - IHC is useful (see below) the ducts should all be lined by myoepithelium.


===Images===
===Images===
Line 60: Line 68:
Image:Nipple_adenoma_-_intermed mag.jpg | Nipple adenoma - intermed. mag. (WC/Nephron)
Image:Nipple_adenoma_-_intermed mag.jpg | Nipple adenoma - intermed. mag. (WC/Nephron)
Image:Nipple_adenoma_-_very_high_mag.jpg | Nipple adenoma - very high mag. (WC/Nephron)
Image:Nipple_adenoma_-_very_high_mag.jpg | Nipple adenoma - very high mag. (WC/Nephron)
Image:Breast NippleAdenoma LP SNP.jpg|Breast Nipple Adenoma - low power (SKB)
Image:Breast NippleAdenoma MP SNP.jpg|Breast Nipple Adenoma - medium power (SKB)
Image:Breast NippleAdenoma MP2 SNP.jpg|Breast Nipple Adenoma - medium power (SKB)
Image:Breast NippleAdenoma LP2 14BR***.jpg|Breast Nipple Adenoma - low power (SKB)
Image:Breast NippleAdenoma LP 14BR***.jpg|Breast Nipple Adenoma - low power (SKB)
Image:Breast NippleAdenoma MP 14BR***.jpg|Breast Nipple Adenoma - medium power (SKB)
Image:Breast NippleAdenoma CK5 14BR***.jpg|Breast Nipple Adenoma - CK5 (SKB)
Image:Breast NippleAdenoma CK14 14BR***.jpg|Breast Nipple Adenoma CK14 (SKB)
Image:Breast NippleAdenoma SMA 14BR***.jpg|Breast Nipple Adenoma - SMA (SKB)
Image:Breast NippleAdenoma p63 14BR***.jpg|Breast Nipple Adenoma -  p63 (SKB)
</gallery>
</gallery>
www:
www:
Line 66: Line 84:
==See also==
==See also==
*[[Breast pathology]].
*[[Breast pathology]].
*[[Intraductal papilloma]].
*[[Intraductal papilloma of the breast]].


==References==
==References==

Latest revision as of 21:17, 9 May 2016

Nipple adenoma is a benign pathology of the breast.

Nipple adenoma
Diagnosis in short

Nipple adenoma. H&E stain.
LM proliferation of epithelial and myoepithelial elements that extends into the breast stroma; not encapsulated; lacks true fibrovascular cores, +/-focal necrosis
LM DDx intraductal papilloma of the breast
Site breast - nipple
Prevalence uncommon
Prognosis benign
Clin. DDx Paget's disease of the breast

It is also known as nipple duct adenoma, nipple adenoma of breast, adenoma of the nipple and florid papillomatosis of the nipple.[1]

General

  • A benign lesion with papillary architecture arising at the nipple.
  • Rare.[2]
  • Reported in men.[1]

Clinical DDx:

Microscopic

Features:

  • Not encapsulated.[4]
  • Proliferation of epithelial and myoepithelial elements that extends into the breast stroma.[4]
  • Arborising papillomatous epithelial proliferation within duct
  • (Papillae have fibrovascular cores) at least as far as I can see but not according to Stanford.
  • Florid epithelial hyperplasia can be seen
  • Can see haphazard arrangement of proliferating tubular structures

Notes:

  • Lacks true fibrovascular cores.[5]
  • Focal necrosis may be present.[6]

DDx:

  • Intraductal papilloma of the breast.
    • Found within the duct not the stroma.
    • Often deeper - one should not see skin in the histologic section.
  • Syringomatous adenoma
  • Intraductal carcinoma - the proliferation in nipple adenoma should be no more atypical than that seen with usual intraductal hyperplasia or intraductal papillomatosis. Cribriforming glands should be absent
  • Invasive ductal carcinoma - IHC is useful (see below) the ducts should all be lined by myoepithelium.

Images

  • Nipple adenoma - low mag. (WC/Nephron)

  • Nipple adenoma - intermed. mag. (WC/Nephron)

  • Nipple adenoma - very high mag. (WC/Nephron)

  • Breast Nipple Adenoma - low power (SKB)

  • Breast Nipple Adenoma - medium power (SKB)

  • Breast Nipple Adenoma - medium power (SKB)

  • Breast Nipple Adenoma - low power (SKB)

  • Breast Nipple Adenoma - low power (SKB)

  • Breast Nipple Adenoma - medium power (SKB)

  • Breast Nipple Adenoma - CK5 (SKB)

  • Breast Nipple Adenoma CK14 (SKB)

  • Breast Nipple Adenoma - SMA (SKB)

  • Breast Nipple Adenoma - p63 (SKB)

www:

See also

References

  1. ↑ 1.0 1.1 Boutayeb, S.; Benomar, S.; Sbitti, Y.; Harroudi, T.; Hassam, B.; Errihani, H. (2012). "Nipple adenoma in a man: An unusual case report.". Int J Surg Case Rep 3 (5): 190-2. doi:10.1016/j.ijscr.2011.05.008. PMID 22342578.
  2. ↑ Shinn, L.; Woodward, C.; Boddu, S.; Jha, P.; Fouroutan, H.; Péley, G.. "Nipple adenoma arising in a supernumerary mammary gland: a case report.". Tumori 97 (6): 812-4. doi:10.1700/1018.11102. PMID 22322852.
  3. ↑ HANDLEY, RS.; THACKRAY, AC. (Jun 1962). "Adenoma of nipple.". Br J Cancer 16: 187-94. PMC 2070922. PMID 13904317. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2070922/?tool=pubmed.
  4. ↑ 4.0 4.1 "Adenoma of Nipple.". Br Med J 1 (5330): 563. Mar 1963. PMC 2123505. PMID 20789667. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2123505/?page=1.
  5. ↑ URL: http://surgpathcriteria.stanford.edu/breast/nippleadenoma/printable.html. Accessed on: 6 August 2011.
  6. ↑ Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 307 Q16. ISBN 978-1416025887.
Retrieved from "https://librepathology.org/w/index.php?title=Nipple_adenoma&oldid=44309"