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Difference between revisions of "Talk:Breast pathology"
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→Phyllodes: new section
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The sections show a well-circumscribed breast nodule that separates from the surrounding fibrous tissue. It has a pale pink staining, dense, cellular stroma that consists of cells with bland nuclear features. The epithelial component consists of a variable cell population with nuclei that are small and round to oval and do not have an easy-to-identify nucleolus. There are more than three cells above the basement membrane. Mitotic activity is seen focally. No atypical mitoses are identified. | The sections show a well-circumscribed breast nodule that separates from the surrounding fibrous tissue. It has a pale pink staining, dense, cellular stroma that consists of cells with bland nuclear features. The epithelial component consists of a variable cell population with nuclei that are small and round to oval and do not have an easy-to-identify nucleolus. There are more than three cells above the basement membrane. Mitotic activity is seen focally. No atypical mitoses are identified. | ||
The surrounding breast parenchyma has | The surrounding breast parenchyma has focal cystic glandular dilation and epithelium with a columnar cell morphology and apocrine snouts. There is a small focus of glands without significant mitotic activity, an increased epithelial component with slit-like spaces, and nuclei that are small and round to oval. | ||
===Final diagnosis=== | ===Final diagnosis=== | ||
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Fibrocystic changes.<br> | Fibrocystic changes.<br> | ||
Columnar cell change.<br> | Columnar cell change.<br> | ||
== Phyllodes == | |||
===Microscopic=== | |||
The specimen consists of a close excision lumpectomy. | |||
The sections show a moderately well-circumscribed fibroepithelial lesion, that focally has an irregular interface to the surround breast tissue. It has long slit-like spaces that together give the a leaf-like appearance. The stromal component is mitotically active (10 mitoses / 2.376 mm^2 ) and has moderate nuclear atypia. There is no stromal overgrowth. The epithelial component of the lesion has no nuclear atypia and is not mitotically active. The surgical margin is 0.1 cm from the lesion. | |||
The surrounding breast parenchyma has a small focus of glands without significant mitotic activity, an increased epithelial component -- with more than three cells to the basement membrane, and nuclei that are small and round to oval. There is also focal cystic glandular dilation and epithelium with a columnar cell morphology and apocrine snouts. Calcifications are found in benign breast glands. | |||
The focally irregular interface between the lesion and surrounding breast tissue, and the mitotic rate is concerning for an aggressive (phyllodes) tumour; however other features that typically accompany a malignant behaviour (stromal overgrowth, marked stromal cell nuclear atypia) are absent. | |||
===Final=== | |||
DIAGNOSIS:<br> | |||
Breast, left, (close excision) lumpectomy:<br> | |||
Phyllodes tumour with:<br> | |||
Marked cellular proliferation, and | |||
Focally irregular interface to surround breast tissue – suggest re-excision of lumpectomy cavity. | |||