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Presented by Jonathan Epstein, M.D. and prepared by Orin Buetens, M.D.
Case 1: 55 year-old female with needle biopsy of a breast mass
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Question 1 of 1
1. Question
Week 7: Case 1
55 year-old female with needle biopsy of a breast mass
Correct
Answer: Tubular carcinoma
Histology: Within one of the fragments is a proliferation of tubules with a haphazard appearance. Tubules extend into surrounding adipose tissue. They vary from those that are round to those with an angular, pointed appearance. The connective tissue in between the tubules is somewhat myxoid in appearance.
Discussion: Radial scar consists of a hyalinized acellular stroma with embedded tubules, often resembling tubular carcinoma. However, in a radial scar, in addition to the acellularity of the stroma at the periphery, the tubules merge in with more typical usual duct hyperplasia. In this needle biopsy, the tubules are seen extending into the fat- this is only uncommonly seen focally in a radial scar. Sclerosing adenosis at low magnification has an overall organized growth pattern. It consists of a more lobular lesion where the tubules are more open on the perimeter and more compressed into cords and individual cells towards the center. Microglandular adenosis shares with tubular carcinoma the presence of tubules within fat. However, in microglandular adenosis the tubules are perfectly round and often contain dense eosinophilic colloid secretions. Classically, microglandular adenosis lacks a prominent stromal reaction.
Incorrect
Answer: Tubular carcinoma
Histology: Within one of the fragments is a proliferation of tubules with a haphazard appearance. Tubules extend into surrounding adipose tissue. They vary from those that are round to those with an angular, pointed appearance. The connective tissue in between the tubules is somewhat myxoid in appearance.
Discussion: Radial scar consists of a hyalinized acellular stroma with embedded tubules, often resembling tubular carcinoma. However, in a radial scar, in addition to the acellularity of the stroma at the periphery, the tubules merge in with more typical usual duct hyperplasia. In this needle biopsy, the tubules are seen extending into the fat- this is only uncommonly seen focally in a radial scar. Sclerosing adenosis at low magnification has an overall organized growth pattern. It consists of a more lobular lesion where the tubules are more open on the perimeter and more compressed into cords and individual cells towards the center. Microglandular adenosis shares with tubular carcinoma the presence of tubules within fat. However, in microglandular adenosis the tubules are perfectly round and often contain dense eosinophilic colloid secretions. Classically, microglandular adenosis lacks a prominent stromal reaction.
