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Anatomic pathology > Breast > Flashcards

Flashcards in Breast Deck (253)
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1

Plasma-cell mastitis: Clinical appearance.

May evolve into a hard mass that, together with axillary lymphadenopathy, can mimic carcinoma.

2

Plasma-cell mastitis: Inflammatory changes (2).

Extensive lymphoplasmacytic infiltrate.

Xanthomatous reaction sometimes.

3

Plasma-cell mastitis: Epithelial changes (2).

Hyperplasia, necrosis.

4

Plasma-cell mastitis: Special stains.

Negative: GMS, PAS, AFB.

5

Subareolar abscess:

A. Surgical association.
B. Clinical appearance.

A. Reduction mammoplasty.

B. Can mimic that of inflammatory carcinoma.

6

Subareolar abscess: Causes (5).

Staphylococcus.

Streptococcus.

Bacteroides.

Proteus.

Mycobacterium tuberculosis.

7

Subareolar abscess: Epithelial changes (2).

Squamous metaplasia of ducts.

Keratin plugs in lactiferous ducts.

8

Plasma-cell mastitis: Typical patient.

Woman who has stopped lactating years ago.

8

Granulomatous mastitis:

A. Etiology.
B. Clinical appearance.

A. Unknown.

B. Hard mass that may mimic carcinoma.

9

Granulomatous mastitis: Histology (2).

Granulomatous inflammation of lobules.

Giant cells, plasma cells, and eosinophils accompany the granulomas.

10

Granulomatous mastitis vs. sarcoidosis.

Sarcoidosis: Noncaseating, naked granulomas that are usually found between the lobules.

11

Granulomatous mastitis: Behavior.

May recur and require many excisions.

12

Fat necrosis: Clinical appearance.

May mimic carcinoma clinically and on mammogram.

13

Fat necrosis: Later histologic changes (3).

Fibroblasts and collagen deposition.

Scar.

Calcification ("eggshell calcifications") on mammogram.

14

Diabetic mastopathy: Typical patient.

Premenopausal woman with diabetes of the first type.

15

Diabetic mastopathy:

A. Clinical appearance (2).
B. Mamographic appearance.

A. Hard, mobile mass; often bilateral.

B. Nonspecific.

16

Diabetic mastopathy: Histology (3).

Densely fibrotic, keloid-like stroma.

Lymphocytes around small vessels, lobules, ducts.

Calcifications may be visible.

17

Juvenile hypertrophy:

A. Age of patient.
B. Mammographic appearance.

A. Less than 16 years.

B. Benign.

18

Juvenile hypertrophy: Histology (2).

Proliferation of ducts and connective tissue but not of lobules.

May resemble gynecomastia.

19

Juvenile hypertrophy: Genetics.

Most cases are sporadic.

Cases with PTEN mutation are more likely to turn malignant.

20

Granular-cell tumor:

A. Typical location.
B. Mammographic appearance.

A. Upper inner quadrant.

B. Mimics carcinoma.

21

Granular-cell tumor: Immunohistochemistry (2,1).

Positive: S100, CEA.

Variable: CD68.

22

Granular-cell tumor: Electron microscopy (2).

Many lysosomes.

Myelin figures.

23

Granular-cell tumor: Morphologic differential diagnosis (4).

Apocrine carcinoma.

Metastatic renal-cell carcinoma.

Metastatic melanoma.

Metastatic alveolar soft-part sarcoma.

24

Granular-cell tumor: Treatment.

Ya gotta cut it all out, or it might come back.

25

Fibrocystic changes: Histologic components (5).

Cysts.

Stromal fibrosis.

Apocrine metaplasia.

Sclerosing adenosis.

Epithelial hyperplasia without atypia.

26

Fibrocystic disease: Risk of carcinoma.

Sclerosing adenosis and florid ductal hyperplasia without atypia: Slightly increased risk.

All other changes: No increase in risk.

27

Columnar-cell lesions: Types (3).

Columnar-cell change.

Columnar-cell hyperplasia.

Flat epithelial atypia.

28

Columnar-cell lesions: Histologic location.

Terminal ductal-lobular units.

29

Columnar-cell change: Histology (4).

Dilated acini.

Bland, mitotically inactive cells.

Up to two layers of epithelium.

Apocrine snouts and luminal secretions may be visible.