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Difference between revisions of "Nipple adenoma"
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| 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 = | ||
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==General== | ==General== | ||
*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> | *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/> | ||
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==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: | ||
*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=== | ||
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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: | ||
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==See also== | ==See also== | ||
*[[Breast pathology]]. | *[[Breast pathology]]. | ||
*[[Intraductal papilloma]]. | *[[Intraductal papilloma of the breast]]. | ||
==References== | ==References== | ||