Talk:Breast pathology

Case with everything

Microscopic

1. The sections show breast tissue with a partially fibrous breast stroma, and glands with columnar cells, apocrine snouts and moderate, focal nuclear atypia in which nucleoli are easy to identify at the intermediate power objective. The glandular cells layer up to three cells thick. There are also glands with a columnar cell morphology and apocrine snouts, and dilated glands with flat and benign appearing epithelium. There is a focus of breast glands with a columnar cell morphology and apocrine snouts, with pale periglandular stroma. Focal microcalcifications, approximately 50-80 micrometers in size, are seen in benign breast glands.

1. The section small blood vessel-like channels in a dense, abundant interlobular stromal tissue. There are also glands with a columnar cell morphology and apocrine snouts, and dilated glands with flat and benign appearing epithelium.

Final diagnosis

1. Left breast, lumpectomy:
   • Flat epithelial atypia.
   • Columnar cell change.
   • Fibrocytic change.
   • Focal fibroadenomatoid change.
   • Microcalcifications in benign breast glands.
2. Left breast, lumpectomy:
   • Pseudoangiomatous stromal hyperplasia.
   • Columnar cell change.
   • Fibrocystic change.

Fibroadenoma

Microscopic

Thank you for the consult.

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 small calcifications in benign epithelium, 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

Breast, right, excisional biopsy for a nodule:
Fibroadenoma with epithelial hyperplasia.
Fibrocystic changes.
Columnar cell change.