breast path Flashcards
(33 cards)
what is the path of gyenocomastia
high estrogen/androgen imblance
will cause an increase in subareolar, rubbery discrete mass
what is the morphology of gyenocomastia
terminal duts without lobule–because no period formation
the ducts are lined by aMULTILAYERED EPITHELIUM with small papillary tufts (epithelial hyperplasia)
*periductal hyalinization and fibrosis seen
what conditions also have a imbalance in androgen and estrogens leading to gynecomastia
- cirrhosis of liver
- klinefelter syndrome
- leydig cell tumor
- drugs- DIGOXIN, SPIRONOLACTONE, KETOCONAZOLE
what is the path of acute mastitis
when breastfeeding there is cracks in the breast and the bacteria from the babies mouth causes infection (Staph. aureus)
CF of acute mastitis
breast is erythematous and painful and fever is present
morphology of acute mastits
- neutrophlis and necrotic material
- heals by scarring and may look like a nipple retraction
tx- is antibiotics
what are other names for periductal mastitis
- recurrent subareolar abscess
- SQUAMOUS METAPLASIA of the lactiferous ducts
- Zuska disease
CF of periductal mastitis
-painful, erythematous subareolar abscess
-FISTULA FORMATION in recurrent cases- at the edge of the areola/beneath the smooth muscle
-may have a inverted nipple
**STRONGLY ASSOCIATED WITH CIG SMOKING AND VIT A DEF.
morpholgy of periductal mastitis
*keratinising squamous metaplasia
KERATIN PLUGS—dilation and rupture of ducts
**intense chronic and granulomatous response around the spilled keratin
what is the path of mammary duct ectasia
open/dilated duct
CF of mammary duct ectasia
poorly defined and palpable periareolar mass with thick green nipple discharge
no pain or erythema
-produces a irregular palpable mass– mimics carcinoma due to calcifaction
morphology of mammary duct ectasia
lipid-laden macrophages and debris
marked- periductal chronic inflammation (plasma cells)
- FIBROSIS
path of FAT Necrosis
trauma
CF of fat necrosis
- painless palpable mass with skin retraction
morphology of fat necrosis
initially- necrotic fat with neutrophils
later- foamy lipid-filled macrophages, giant cells and lymphocytes
finally- walled of by scar tissue and calcifation
what is the path of nonproliferative breast changes (FIBROCYSTIC CHANGES)
its a benign epithelial lesion
describe the cyst componet of fibrocystic changes
- turbid, semi-translucent fluid that produces a brown and blue color
- lined by flattened atrophic epithelium or by metaplastic apocrine cells
- calcifaction are very common
- MILK of calcifation
tx: needle aspiration
describe the fibrosis component of FIBROCYSTIC CHANGES
cyst will frequently rupture, releasing secretory material into the adjacent stroma
- resulting in chronic inflammation and fibrosis causes it to be firm
describe the adenosis of the fibrocystic changes
- increase in the number of ACINI per lobule
- acini are lined by columar cells, which may appear benign or show mild atypia
what is the risk accociated with proliferative lesion without atypia (PLWA)
what is the diffrence between proliferative without atypia and nonproliferative changes
non-proliferative changes include stromal fibrosis and cyst formation
while proliferative has the non-proliferative changes plus epithelial hyperplasia, sclerosing adenosis, and papillomas
epithelial hyperplasia features
- there is increase in the number of CELLS over the basement membrane in a duct or lobule
-there is proliferation of epithelial and myoepithelial cells which distend and fill the lumen
*IRREGULAR SLIT LIKE LUMEN AT THE PERIPHERY
features of sclerosing adenosis
proliferation of both acini and stroma
the lobular arrangment is maintanted
- acini are compressed and distorted in the central and dilated at the periphery
- there is fibrosis of stroma, apperance of solid cords or double strands of cells lying within the dense stroma – calcifaction present
papillomas path
torsion of the stalk leading to blood stained nipple discharge
