Breast Pathology: Intraductal epithelial proliferations

Usual type epithelial hyperplasia:

  • Peripheral slit like spaces
  • Streaming
  • Mixed population
  • Uneven distribution and overlapping of nuclei
  • Variation in appearances including oval nuclei
  • mosaic pattern of staining with Ck5, Ck14 and ER pos
  • punctate necrosis and ocasional nonatypical mitoses may be present
  • x2 risk of breast ca

Atypical ductal hyperplasia

  • Features of UEH & LGDcis
  • cells similar to LGDcis
  • <2 duct spaces with complete involvement or <2mm
  • CK5 & Ck14 neg, ER pos
  • x4 risk of breast ca

Low grade Dcis

  • uniformity
  • punched out spaces
  • rigid bars
  • micropapillae
  • evenly spaced
  • small, regular, round nuclei
  • CK5 & Ck14 neg, ER pos

Gynaecomastoid hyperplasia

  • rudimentary ill defined micropapillary clusters
  • taper towards lumen
  • small pyknotic nuclei arranged around outer edge of micropapillae
  • variable nuclei

References:

Breast Pathology: Francis, Pinder, Mulligan

Pathology Reporting of Breast Disease. Jan 2005. NHS Breast Screening Programme

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