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Presented by Pedram Argani, M.D. and prepared by Jeffrey T. Schowinsky, M.D.
Case 1: 12 year old female with bilateral breast enlargement.
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Question 1 of 1
1. Question
Week 282: Case 1
12 year old female with bilateral breast enlargement./images/091106PA1a.jpg
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/images/091106PA1e.jpgCorrect
Answer: Juvenile hypertrophy
Histology: The specimen is characterized by both stromal and epithelial proliferation. The epithelium shows micropapillary, gynecomastoid hyperplasia; the micropapillae taper as they project into the lumen. This contrasts with micropapillary ductal carcinoma in situ, which contains bulbous intraluminal projections.
Discussion: Juvenile fibroadenoma is histologically identical to juvenile (virginal) hypertrophy of the breasts. Juvenile fibroadenoma is typically unilateral and displaces the nipple, in contrast to juvenile hyperplasia. Gynecomastia resembles juvenile hyperplasia in that it consists of stromal hyperplasia in a lobule-poor breast, and the ducts show micropapillary hyperplasia. Gynecomastia is seen in the male breast in association with factors that increase the estrogen to androgen ratio. Phyllodes tumors have infiltrative borders, are unilateral lesions, often show cytologic atypia, and feature a prominent intracanalicular growth pattern.
Incorrect
Answer: Juvenile hypertrophy
Histology: The specimen is characterized by both stromal and epithelial proliferation. The epithelium shows micropapillary, gynecomastoid hyperplasia; the micropapillae taper as they project into the lumen. This contrasts with micropapillary ductal carcinoma in situ, which contains bulbous intraluminal projections.
Discussion: Juvenile fibroadenoma is histologically identical to juvenile (virginal) hypertrophy of the breasts. Juvenile fibroadenoma is typically unilateral and displaces the nipple, in contrast to juvenile hyperplasia. Gynecomastia resembles juvenile hyperplasia in that it consists of stromal hyperplasia in a lobule-poor breast, and the ducts show micropapillary hyperplasia. Gynecomastia is seen in the male breast in association with factors that increase the estrogen to androgen ratio. Phyllodes tumors have infiltrative borders, are unilateral lesions, often show cytologic atypia, and feature a prominent intracanalicular growth pattern.
