Final - new material Flashcards Preview

Pathology III > Final - new material > Flashcards

Flashcards in Final - new material Deck (66)
Loading flashcards...
1

Anytime a male or non-gravid female is producing breast discharge:

galactorrhea

MC from hormonal dysregulation or side-effect from several meds (OCPs)
excess prolactin expressed, mb from prolactinoma

2

The breasts are modified ___________:

sweat glands

3

The lactiferous duct system contains _________ ducts, which correspond to ____ openings at the nipple.

4-18

each duct opens to the nipple (equal #)

4

% of breast cancer found in each quadrant:

Upper Outer - 58%***

Upper Inner - 17%
Lower Outer - 12%
Lower Inner - 13%

5

The lactiferous ducts and lobules are lined by 2 cell types:

luminal epithelium cells - milk production
myoepithelial cells - assist lactation (ejection); normal structure/function

6

___% of lymph flow from breast travels to _____ node system:

75%
axillary [includes pectoral, sub-scap, humeral]

7

How are stroma & parenchyma different?

Stroma - non-functional, connective tissue, supportive framework.

Parenchyma - functional parts of an organ; in cancer, the mutant cells.

8

Amastia:

absent breast tissue/nipple/areola

9

Amazia:

absent mammary gland tissue
nipple/areola present

10

Athelia:

absent nipple or areola
glandular tissue present

11

In the ___ decade breast stromal tissues begin to involute, and at ________ diminish/disappear, replaced by adipose.

3rd decade
menopause

12

Estrogen stimulates what:

epithelial cell proliferation
ductal elongation/branching
increased volume & elasticity of CT/ducts
increased adipose tissue

13

Progesterone stimulates what:

increased lobule formation
increased size of acini/lumen/ducts

14

The glands on the areola are called _________ and function to:

Montgomery tubercles (sebaceous glands)
lubricate nipple

15

Breast histology - 1st trimester:
3rd trimester:

1st - acinar proliferation
stromal involution
minimal secretory changes

3rd - lobular proliferation
cells enlarged, increased cytoplasm, lg nuclei
dramatic stromal involution

16

Inverted nipples are familial in ___% of cases,
bilateral in ____% of cases,
and present in ___% of the population.

familial - 50%
bilateral - 90%
incidence - 3%

17

When is an inverted nipple a red flag sign?

When it is a new onset in absence of a known cause

18

Galactorrhea is disconcerting when:

unilateral
bloody
assoc w/mass

19

Inflammation of the parenchyma of the mammary gland:

Mastitis

usu. when lactating -> puerperal

20

When found to be infectious in cause, mastitis is usu d/t:

staph aureus OR strep epidermitis

generally enters via cracks/fissures in nipple

21

Peri-ductal mastitis usu presents as:

painful mass in the sub-areolar area
overlying skin erythema
>90% are smokers
nipple inversion may occur

22

Peri-ductal mastitis - histology:

keratinizing squamous epithelium in the duct system
extends to abn depth
chronic granulomatous inflammatory response
dilation/rupture of ducts

23

Mammary duct ectasia is:
commonly seen in:

dilatation of the sub-areolar ducts
often unilateral, but mb bilateral

5th or 6th decade
multiparous women

24

Mammary duct ectasia - clinical presentation:

breast pain
overlying erythema
palpable areolar or peri-areolar mass
poorly defined mass
mb thick secretions from nipple
mb nipple inversion (30-40%)

25

Mammary duct ectasia - histology:

dilated lactiferous ducts
granular debris -> inc foamy (lipid) macrophages
infiltration of lymphs & macrophages
inc plasma cells

26

Condition characterized by fibrous lumps & cords in breast tissue that are non-cancerous:

Fibrocystic breast dz

30-60% of women
frequently dx'd at 20-40 yo
uncommon before adolescence/after menopause

27

Fibrocystic breast changes are most often found:
Dx:

in the upper outer quadrant

mammography - limited value, mb too dense to visualize
bx or aspiration - definitive

28

Fibrocystic breast - histology:

fibrosis - dense collagen
sclerosing ductal epithelial proliferation - round ducts inc in size
adenosis - full of glands
apocrine metaplasia - lg cystic spaces, fluid-filled

29

MC occurs as result of prior breast trauma or 2° to breast surgery:

fat necrosis

adipocyte rupture -> lipolysis, converted to fatty acid + glycerol -> fibroblastic proliferation, inc vascularization -> calcification, hemosiderin deposition

presents as painless breast mass, skin thickening, mb tissue retraction -> looks like malignant neoplasm

30

Fat necrosis - on mammogram:

central radiolucent area of fat w/inc density
calcifications at fat periphery

bx follows if mammo fails to r/o cancer