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Presented by Pedram Argani, M.D. and prepared by Doreen Nguyen, M.D.
Case 1: This is a 48-year-old female with a breast mass.
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Question 1 of 1
1. Question
Week 602: Case 1
This is a 48-year-old female with a breast mass.images/D Nguyen/10-20-14/case 1/2X_scar2_450 pixels.jpg
images/D Nguyen/10-20-14/case 1/2X_scar_450 pixels.jpg
images/D Nguyen/10-20-14/case 1/10X_small_glands_450 pixels.jpg
images/D Nguyen/10-20-14/case 1/20X_adenosis_450 pixels.jpg
images/D Nguyen/10-20-14/case 1/10X_small_glands2_450 pixels.jpgCorrect
Answer: Radial scar
Histology: This is a sclerosing lesion with an overall lobular architecture. The central part of the lesion has a fibroelastic stroma and angulated entrapped tubules within. The rounded periphery of the lesion consists of dilated ducts, some of which are filled by usual duct hyperplasia. The cells filling these ducts are polymorphous in their appearance, have indistinct cell borders, have variably shaped nuclei, and have open chromatin. Overall, these are the typical features of a radial scar.
Discussion: Invasive well differentiated ductal carcinoma would have an infiltrative appearance at low power, and the small atypical glands would lack myoepithelial layer. The epithelial proliferation in the current lesion has features of usual duct hyperplasia described above. Ductal carcinoma in situ of low grade would consist of a monotonous population of epithelial cells with distinct cell borders and hyperchromatic nuclei. Microglandular adenosis would consist of an irregular, infiltrative proliferation of rounded tubules which contain dense eosinophilic secretions.
Incorrect
Answer: Radial scar
Histology: This is a sclerosing lesion with an overall lobular architecture. The central part of the lesion has a fibroelastic stroma and angulated entrapped tubules within. The rounded periphery of the lesion consists of dilated ducts, some of which are filled by usual duct hyperplasia. The cells filling these ducts are polymorphous in their appearance, have indistinct cell borders, have variably shaped nuclei, and have open chromatin. Overall, these are the typical features of a radial scar.
Discussion: Invasive well differentiated ductal carcinoma would have an infiltrative appearance at low power, and the small atypical glands would lack myoepithelial layer. The epithelial proliferation in the current lesion has features of usual duct hyperplasia described above. Ductal carcinoma in situ of low grade would consist of a monotonous population of epithelial cells with distinct cell borders and hyperchromatic nuclei. Microglandular adenosis would consist of an irregular, infiltrative proliferation of rounded tubules which contain dense eosinophilic secretions.
