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Presented by Ralph Hruban, M.D. and prepared by Sharon Swierczynski, M.D., Ph.D.
Case 5: This patient had a breast biopsy for microcalcifications.
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1. Question
Week 168: Case 5
This patient had a breast biopsy for microcalcifications. The lesion shown is in breast parenchyma adjacent to the area with microcalcification./images/010504case5fig1.jpg
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/images/010504case5fig4.jpgCorrect
Answer: In-situ lobular carcinoma
Histology: The lobules are distended by uniform round cells with uniform round nuclei. Occasional signet ring cells are present.
Discussion: The distinction between lobular hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ (LCIS) is made on a quantitative basis. In LCIS there is a complete filling and distention of at least half of the acini in a lobular unit. Patients with LCIS have a 13% chance of developing carcinoma after 12 years. This carcinoma can be either of lobular or ductal type, and both breasts are at risk.
Incorrect
Answer: In-situ lobular carcinoma
Histology: The lobules are distended by uniform round cells with uniform round nuclei. Occasional signet ring cells are present.
Discussion: The distinction between lobular hyperplasia, atypical lobular hyperplasia, and lobular carcinoma in situ (LCIS) is made on a quantitative basis. In LCIS there is a complete filling and distention of at least half of the acini in a lobular unit. Patients with LCIS have a 13% chance of developing carcinoma after 12 years. This carcinoma can be either of lobular or ductal type, and both breasts are at risk.
