Difference between revisions of "Intraductal papilloma of the breast"
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'''Intraductal papilloma''', also '''papilloma''', is a relatively common benign [[breast pathology|pathology of the breast]]. | '''Intraductal papilloma of the breast''', also '''papilloma''' and '''[[intraductal papilloma]]''', is a relatively common benign [[breast pathology|pathology of the breast]]. | ||
==General== | ==General== | ||
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*Lacks florid hyperplasia.<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 florid hyperplasia.<ref>URL: [http://surgpathcriteria.stanford.edu/breast/nippleadenoma/printable.html http://surgpathcriteria.stanford.edu/breast/nippleadenoma/printable.html]. Accessed on: 6 August 2011.</ref> | ||
*May degeneration and hyalinize to form a ''sclerosing papilloma''. | *May degeneration and hyalinize to form a ''sclerosing papilloma''. | ||
*When many ducts are involved the process is termed 'papillomatosis'. | |||
DDx: | DDx: | ||
| Line 51: | Line 52: | ||
*Intraductal papilloma with [[atypical ductal hyperplasia]]. † | *Intraductal papilloma with [[atypical ductal hyperplasia]]. † | ||
*Intraductal papilloma with [[ductal carcinoma in situ]]. † | *Intraductal papilloma with [[ductal carcinoma in situ]]. † | ||
*[[Ductal carcinoma in situ]] - papillary variant | |||
*[[Invasive papillary carcinoma of the breast]]. | *[[Invasive papillary carcinoma of the breast]]. | ||
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Image:Intraductal papilloma histopathology (2) smooth muscle actin.JPG | IP - SMA. (WC/KGH) | Image:Intraductal papilloma histopathology (2) smooth muscle actin.JPG | IP - SMA. (WC/KGH) | ||
Image:Intraductal_papilloma_histopathology_(3)_p63.JPG | IP - p63 (WC/KGH) | Image:Intraductal_papilloma_histopathology_(3)_p63.JPG | IP - p63 (WC/KGH) | ||
Image:Breast IntraductalPapillomatosis LP CTR.jpg|Breast - Intraductal Papillomatosis with some usual type epithelial hyperplasia - Low power (SKB) | |||
Image:Breast IntraductalPapillomatosis MP2 CTR.jpg|Breast - Intraductal Papillomatosis with some usual type epithelial hyperplasia - Medium power (SKB) | |||
Image:Breast IntraductalPapilloma LP PA.JPG|Breast - Intraductal Papilloma - Low power (SKB) | |||
Image:Breast IntraductalPapilloma MP PA.JPG|Breast - Intraductal Papilloma - Medium power (SKB) | |||
Image:Breast IntraductalPapilloma HP PA.JPG|Breast - Intraductal Papilloma - High power (SKB) | |||
Image:Breast IntraductalPapilloma LP (2) PA.JPG|Breast - Intraductal Papilloma - Low power (SKB) | |||
Image:Breast IntraductalPapilloma Histiocytes MP PA.JPG|Breast - Intraductal Papilloma - Histiocytes - High power (SKB) | |||
</gallery> | </gallery> | ||
==IHC== | |||
< | Features:<ref name=pmid22612506>{{Cite journal | last1 = Furuya | first1 = C. | last2 = Kawano | first2 = H. | last3 = Yamanouchi | first3 = T. | last4 = Oga | first4 = A. | last5 = Ueda | first5 = J. | last6 = Takahashi | first6 = M. | title = Combined evaluation of CK5/6, ER, p63, and MUC3 for distinguishing breast intraductal papilloma from ductal carcinoma in situ. | journal = Pathol Int | volume = 62 | issue = 6 | pages = 381-90 | month = Jun | year = 2012 | doi = 10.1111/j.1440-1827.2012.02811.x | PMID = 22612506 }} | ||
</ref> | |||
*[[CK5/6]] +ve. | |||
</ | *[[p63]] +ve. | ||
*MUC3 weak. | |||
*ER weak. | |||
**Strong in [[DCIS]]. | |||
==Sign out== | |||
<pre> | |||
Right Breast, Partial Mastectomy: | |||
- Intraductal papilloma. | |||
- Proliferative fibrocystic changes. | |||
- NEGATIVE for malignancy. | |||
</pre> | |||
==See also== | ==See also== | ||
*[[Breast pathology]]. | *[[Breast pathology]]. | ||
*[[Papillary hidradenoma]]. | *[[Papillary hidradenoma]]. | ||
*[[Intraductal papilloma]]. | |||
==References== | ==References== | ||
Latest revision as of 21:18, 9 May 2016
| Intraductal papilloma of the breast | |
|---|---|
| Diagnosis in short | |
.jpg) Intraductal papilloma. H&E stain. | |
|
| |
| Synonyms | breast papilloma |
|
| |
| LM | true papillae (nipple-shaped structures with fibrovascular cores), intraductal proliferation of epithelial and myoepithelial elements, +/-hyalinization |
| LM DDx | intraductal papilloma with florid epithelial hyperplasia, intraductal papilloma with atypical ductal hyperplasia, intraductal papilloma with ductal carcinoma in situ, invasive papillary carcinoma of the breast. |
| Site | breast |
|
| |
| Signs | +/-nipple discharge |
| Prevalence | common |
| Prognosis | benign |
| Treatment | usually excision |
Intraductal papilloma of the breast, also papilloma and intraductal papilloma, is a relatively common benign pathology of the breast.
General
- May cause nipple discharge.[1]
- Similar to papillary hidradenoma of the vulva.
- Usually excised to exclude malignancy.
- Risk very low if not associated with a mass or suspicious radiologic findings - conservative management may be reasonable.[2]
Microscopic
Features:
- True papillae - nipple-shaped structures with fibrovascular cores.
- Intraductal proliferation of epithelial and myoepithelial elements.[3]
Notes:
- Lacks florid hyperplasia.[4]
- May degeneration and hyalinize to form a sclerosing papilloma.
- When many ducts are involved the process is termed 'papillomatosis'.
DDx:
- Intraductal papilloma with florid epithelial hyperplasia.
- Intraductal papilloma with atypical ductal hyperplasia. †
- Intraductal papilloma with ductal carcinoma in situ. †
- Ductal carcinoma in situ - papillary variant
- Invasive papillary carcinoma of the breast.
† Size criteria are different in papillomas.
Images
IP. (WC/KGH)
IP - SMA. (WC/KGH)
IP - p63 (WC/KGH)
Breast - Intraductal Papillomatosis with some usual type epithelial hyperplasia - Low power (SKB)
Breast - Intraductal Papillomatosis with some usual type epithelial hyperplasia - Medium power (SKB)
Breast - Intraductal Papilloma - Low power (SKB)
Breast - Intraductal Papilloma - Medium power (SKB)
Breast - Intraductal Papilloma - High power (SKB)
Breast - Intraductal Papilloma - Low power (SKB)
Breast - Intraductal Papilloma - Histiocytes - High power (SKB)
_smooth_muscle_actin.JPG)
_p63.JPG)
_PA.JPG)
IHC
Features:[5]
Sign out
Right Breast, Partial Mastectomy: - Intraductal papilloma. - Proliferative fibrocystic changes. - NEGATIVE for malignancy.
See also
References
- ↑ Zervoudis, S.; Iatrakis, G.; Economides, P.; Polyzos, D.; Navrozoglou, I. (Jan 2010). "Nipple discharge screening.". Womens Health (Lond Engl) 6 (1): 135-51. doi:10.2217/whe.09.81. PMID 20050819.
- ↑ Weisman, PS.; Sutton, BJ.; Siziopikou, KP.; Hansen, N.; Khan, SA.; Neuschler, EI.; Rohan, SM.; Franz, JM. et al. (Nov 2013). "Non-mass-associated intraductal papillomas: is excision necessary?". Hum Pathol. doi:10.1016/j.humpath.2013.10.027. PMID 24444467.
- ↑ "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.
- ↑ URL: http://surgpathcriteria.stanford.edu/breast/nippleadenoma/printable.html. Accessed on: 6 August 2011.
- ↑ Furuya, C.; Kawano, H.; Yamanouchi, T.; Oga, A.; Ueda, J.; Takahashi, M. (Jun 2012). "Combined evaluation of CK5/6, ER, p63, and MUC3 for distinguishing breast intraductal papilloma from ductal carcinoma in situ.". Pathol Int 62 (6): 381-90. doi:10.1111/j.1440-1827.2012.02811.x. PMID 22612506.