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Difference between revisions of "Florid epithelial hyperplasia"
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Florid epithelial hyperplasia (view source)
Revision as of 13:53, 2 September 2021
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| Caption = Proliferative fibrocystic changes (''florid epithelial hyperplasia'' together with ''fibrocystic breast changes''). [[H&E stain]]. | | Caption = Proliferative fibrocystic changes (''florid epithelial hyperplasia'' together with ''fibrocystic breast changes''). [[H&E stain]]. | ||
| Synonyms = florid epithelial hyperplasia of the usual type, usual ductal hyperplasia, moderate epithelial hyperplasia | | Synonyms = florid epithelial hyperplasia of the usual type, usual ductal hyperplasia, moderate epithelial hyperplasia | ||
| Micro = breast glands with more than four cell layers above the basement membrane with irregular cell spacing (e.g. streaming), slit-like lumina (esp. at the periphery of the duct), no [[DCIS]]-like architecture (not cribriform, not papillary, not micropapillary, not solid), no nuclear atypia - usually no [[nucleoli]] | | Micro = breast glands with more than four cell layers above the basement membrane with irregular cell spacing (e.g. streaming), slit-like lumina (esp. at the periphery of the duct), no [[DCIS]]-like architecture (not [[cribriform]], not papillary, not micropapillary, not solid), no nuclear atypia - usually no [[nucleoli]] | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[mild epithelial hyperplasia]], [[atypical ductal hyperplasia]], cribriform [[ductal carcinoma in situ]] | | LMDDx = [[mild epithelial hyperplasia]], [[atypical ductal hyperplasia]], cribriform [[ductal carcinoma in situ]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = ER "low" (see below), CK5 "high" (see below) | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
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Confusingly, it may be referred to as ''epithelial hyperplasia'', term that is best avoided, as it could lead to confusion with ''[[mild epithelial hyperplasia]]''. | Confusingly, it may be referred to as ''epithelial hyperplasia'', term that is best avoided, as it could lead to confusion with ''[[mild epithelial hyperplasia]]''. | ||
'''Moderate epithelial hyperplasia''' redirects to this article, as it is usually lumped with FEH. '''Proliferative fibrocystic changes''' redirects to this article. | '''Moderate epithelial hyperplasia''' redirects to this article, as it is usually lumped with FEH. '''Proliferative fibrocystic changes''' (abbreviated '''PFCC''') redirects to this article. | ||
==General== | ==General== | ||
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*Irregular cell spacing; streaming. | *Irregular cell spacing; streaming. | ||
*Slit-like lumina, esp. at the periphery of the duct. | *Slit-like lumina, esp. at the periphery of the duct. | ||
*No [[DCIS]]-like architecture (not cribriform, not papillary, not micropapillary, not solid). | *No [[DCIS]]-like architecture (not [[cribriform]], not papillary, not micropapillary, not solid). | ||
*No nuclear atypia - usually no [[nucleoli]]. | *No nuclear atypia - usually no [[nucleoli]]. | ||
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*Cribriform [[ductal carcinoma in situ]] | *Cribriform [[ductal carcinoma in situ]] | ||
===Images | ===Images=== | ||
<gallery> | <gallery> | ||
Image: Proliferative fibrocystic changes -- low mag.jpg |PFCC - low mag. | Image: Proliferative fibrocystic changes -- low mag.jpg |PFCC - low mag. | ||
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Image: Proliferative fibrocystic changes -- very high mag.jpg|PFCC - very high mag. | Image: Proliferative fibrocystic changes -- very high mag.jpg|PFCC - very high mag. | ||
</gallery> | </gallery> | ||
==IHC== | |||
Features:<ref name=pmid19675450>{{Cite journal | last1 = Grin | first1 = A. | last2 = O'Malley | first2 = FP. | last3 = Mulligan | first3 = AM. | title = Cytokeratin 5 and estrogen receptor immunohistochemistry as a useful adjunct in identifying atypical papillary lesions on breast needle core biopsy. | journal = Am J Surg Pathol | volume = 33 | issue = 11 | pages = 1615-23 | month = Nov | year = 2009 | doi = 10.1097/PAS.0b013e3181aec446 | PMID = 19675450 }}</ref> | |||
*ER "low". | |||
*CK5 "high". | |||
Where: | |||
*ER "high" = diffuse strong staining in >90% of cells. | |||
*CK5 "high" = mosaic pattern of staining in >20% of cells | |||
*CK5 "low" = absent or staining in <20% of cells. | |||
Note: | |||
*ADH/DCIS: | |||
**ER "high" | |||
**CK5 "low". | |||
==Sign out== | ==Sign out== | ||
<pre> | |||
A. Left Breast (795 grams), Reduction Mammoplasty: | |||
- Benign breast tissue with usual ductal hyperplasia and skin within normal limits. | |||
B. Right Breast (685 grams), Reduction Mammoplasty: | |||
- Benign breast tissue and skin within normal limits. | |||
</pre> | |||
===UDH with cystic changes=== | |||
<pre> | <pre> | ||
A. Right Breast (570 grams), Reduction Mammoplasty: | A. Right Breast (570 grams), Reduction Mammoplasty: | ||
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==See also== | ==See also== | ||
*[[Breast pathology]]. | *[[Breast pathology]]. | ||
*[[Atypical ductal hyperplasia]]. | |||
==References== | ==References== | ||