Atypical fibroadenoma pathology outlines. Differential diagnosis.

Atypical fibroadenoma pathology outlines Image 11 of 13. 37 year old woman with superficial myofibroblastoma in the vulva (Case Rep Pathol 2019;2019:1582714) 53 year old woman with epithelioid myofibroblastoma mimicking invasive lobular carcinoma (Int J Surg Pathol 2015;23:284) 55 year old postmenopausal woman with 2 cm mass (J Midlife Health 2018;9:47) Atypical apocrine adenosis (AAA): conflicting evidence of increased cancer risk Study of 37 patients showed no increased risk for carcinoma ( Arch Pathol Lab Med 2012;136:179 ) Study of 37 patients showed the relative risk of developing carcinoma was 5. 5 - 3. Sample pathology report. Mandible, left segmental mandibulectomy: Ameloblastoma (2. , seat belt injury after motor vehicle accident) (J Plast Reconstr Aesthet Surg 2015;68:382) Iatrogenic injury: Fine needle aspiration, core needle biopsy, mastectomy or lumpectomy of If the tumor is cutaneous and limited to the dermis of the breast skin (i. Atypical ductal hyperplasia. Fibroadenoma was identified in 2,136 women (noncomplex, 1,835 [85. Board review style question #1. Clinical implications stress patient-centered care, shared decision By definition, fibroadenomatoid change is an incidental finding in a background of fibrocystic change. It is a type of fibroepithelial tumour. 9 - 16), with age association - all patients developing cancer were > 60 years at diagnosis of AAA ( Fibroadenoma (FA) is a common benign breast lesion frequently sampled by fine-needle aspiration biopsy (FNAB). Nuclear outlines: Atypical cells may show uniform outlines with regular outlines A diagnostic dilemma in breast pathology- PathologyOutlines. Right fallopian tube and ovary, salpingo-oophorectomy: Ovary: mucinous cystadenoma Fallopian tube: benign Differential diagnosis. Early pregnancy loss refers to an early, spontaneous, previable pregnancy loss that occurs before 14 weeks gestation. 8 - 2. WebPathology is an educational resource with high quality pathology images of benign and malignant neoplasms and related entities. Left breast, mass, lumpectomy: Pleomorphic adenoma, 3. Left breast, core biopsy: Fibrocystic changes including sclerosing adenosis with microcalcifications. ALK-EML4 fusions are not found in atypical carcinoids (D). Updated information on molecular pathology, expression profiling and molecular classification of breast tumors; Vascular atypical vascular lesion resembling hemangioma. The histologic description matches that of an atypical vascular lesion but to make a confident diagnosis, prior history of irradiation and histologic examination of the entire lesion is essential. 18 year old woman with leiomyosarcoma invading the breast skin (Breast 2011;20:389) PTEN has been regarded as useful in the diagnosis of endometrioid intraepithelial neoplasia / atypical hyperplasia; in fact, PAX2 and PTEN have been used to determine success of progestin therapy in follow up samples; however, the use of these markers has not been validated or widely accepted by the pathology community (Am J Surg Pathol 2022;46:404, Anticancer Typically, the age of presentation can range from 40 - 70 years old although it has been described in children and is rarely seen in men (Hoda: Rosen's Breast Pathology, 4th Edition, 2014) Pain, nipple discharge (can be clear, cloudy or bloody), nipple retraction or a mass (worm-like doughy palpable mass beneath the nipple) can be the clinical presentation (Hoda: Atypical intradermal smooth muscle neoplasm preferred terminology for dermal leiomyosarcoma Reclassification of epithelioid fibrous histiocytoma in family of tumors of uncertain differentiation Skin metastasis Known tumors metastasizing to skin Carcinoma, unknown primary 14 year old boy with eccrine spiradenoma with chondroid syringoma in Blaschkoid distribution (Indian J Dermatol Venereol Leprol 2009;75:600) 20 year old man with chondroid syringoma with extensive bone formation (J Clin Diagn Res 2014;8:FD15) 34 year old man with rapidly growing chondroid syringoma of external auditory canal (Case Rep Med Sample pathology report. 5 cm), nuclear grade 2; lobular neoplasia (atypical lobular hyperplasia / lobular carcinoma in situ), with involvement of a fibroadenoma Comment: Immunohistochemistry shows DCIS to be E-cadherin positive and cytokeratin 5/6 Sample pathology report. Spindle cells Factor VIII, Ulex, CD31, keratin. Fibroadenoma, abbreviated FA, is a common benign tumour of the breast. It was launched in 2003 by Dr. com, free, updated outline surgical pathology clinical pathology pathologist jobs, conferences, fellowships, books Menu Chapters By Subspecialty Cytologic atypia (in the form of highly atypical nuclei) if exposed to radioactive substances Non nodular thyroid is reduced and compressed Incidental papillary thyroid microcarcinoma may coexist References: Neuro Endocrinol Lett Ossifying fibromyxoid tumor (OFMT) is a distinctive mesenchymal neoplasm of uncertain differentiation, with cords, nests, clusters and sheets of uniform ovoid cells embedded in a variable myxoid, fibromyxoid or hyalinized stroma, often with an incomplete peripheral shell of bone (Am J Surg Pathol 1989;13:817) Has potential for local recurrence and metastasis Complex fibroadenoma cytomorphological differs from noncomplex type fibroadenoma in having sheets of ductal and myoepithelial cells. Based on these findings, the fine-needle aspiration cytology was reported as an atypical breast lesion according to The International Academy of Cytology Yokohama system, and the patient Atypical epithelial cells can be found in some cases of fibroadenomas. Rare, benign appearing smooth muscle tumor in lung; may represent hematogenous spread of a uterine leiomyoma or a metastasis of a well differentiated leiomyosarcoma of low malignant potential (Mod Pathol 2006;19:130) Usually women 36 - 64 years, mean 44 years, with history of uterine leiomyoma Atypical secretory change has been reported (Am J Surg Pathol 2004;28:789) May be associated with atypical ductal hyperplasia or ductal carcinoma in situ (Clin Breast Cancer 2015;15:e171) Association with invasive carcinoma is rare (Indian J Pathol Microbiol 2016;59:126, Onkologie 2011;34:448) cellular fibroadenoma resembles phyllodes; complex fibroadenoma (older pt, higher risk of cancer): have cysts, sclerosing adenosis, epithelial calcs, papillary apocrine metaplasia; juvenile fibroadenoma (adolescents): large size, Breast usual ductal hyperplasia and papillary lesions (mosaic-like pattern) (Pathology 2009;41:68) Basal-like breast DCIS (Hum Pathol 2007;38:197) In breast and salivary gland adenoid cystic carcinoma, CK5/6 stains cells lining true lumina (Virchows Arch 2016;469:213, Int J Clin Exp Pathol 2011;4:336) The epithelial component in the nodule showed the typical cytoarchitecture of fibroadenoma but also had some atypical cells. 21 year old woman with rapidly enlarging giant lactating adenoma (J Surg Case Rep 2010;2010:8) 22 year old woman with continuously enlarging lactating adenoma misdiagnosed as malignancy on imaging (Breast J 2019;25:1278) 25 year old lactating woman with co-occurrence of lactating adenoma and 40 year old woman with an asymptomatic red to brown colored hemorrhagic crusted nodule on the left forearm (Ann Dermatol 2011;23:250) 58 year old man had painless, progressive mass below the left temporal eyebrow for 8 years (Indian J Ophthalmol 2020;68:2522) 64 year old man with papules near his left nipple and left ankle (Dermatol Prolymphocytes usually < 15%; 15 - 55% in case of atypical CLL; > 55% defines B cell prolymphocytic leukemia (see Prolymphocytic 2nd Edition, 2016, Foucar: Diagnostic Pathology - Blood and Bone Marrow, 2nd Edition, 2018, Nat Rev Cancer 2016;16:145, Histopathology 2016;69:1066. 21 year old man with Hürthle cell thyroid carcinoma and parathyroid carcinoma (J Clin Diagn Res 2015;9:OD08) 55 year old man with 3 year history of increasing neck mass (University of Pittsburgh: Neck Mass [Accessed 19 October 2017]) 55 year old woman with phyllodes tumor metastatic to Hürthle cell adenoma Sample pathology report. Myoepithelium is retained in atypical ductal hyperplasia and most benign and in situ lesions, with the exception of microglandular adenosis and a few in situ lesions, e. , atypical intradermal smooth muscle neoplasm), rather than arising in the mammary parenchyma, prognosis is excellent without metastases Case reports. 9% Prevalence of atypical endometrial hyperplasia is 1 - 3% Risk of malignancy is 1 - 3% ( Case Rep Obstet Gynecol 2014;2014:518398 ) Risk factors for malignancy: increasing age, obesity, hypertension, postmenopausal status, diabetes, large size of polyps and tamoxifen therapy ( Am J Obstet Gynecol 2006;194:718 , Am J Obstet Gynecol 2009;201:462. Mucinous tumor with focal atypia / proliferation (Hum Pathol 2004;35:949, Hum Pathol 2004;35:918, Am J Molecular pathology is rarely used for diagnosis Hotspot mutations are exclusively found at the IDH1 p. Positive stains. Although the cytologic diagnosis is straightforward in most cases, fibroadenoma pathology pathology in outline format with mouse over histology previews. Diagnosis: Ductal carcinoma in situ (DCIS), solid type, with microcalcifications, confined to a fibroadenoma (0. Which of the If malignancy cannot be excluded, use diagnosis of "atypical mesothelial hyperplasia" and recommend rebiopsy if clinically suspicious (Arch Pathol Lab Med 2012;136:1217) Case reports 43 year old woman with pleural multicystic mesothelial proliferation ( Tuberk Toraks 2013;61:47 ) Localized scleroderma Routine systemic workup is not recommended Clinical presentation Physical examination Localized scleroderma cutaneous assessment tool (LoSCAT) (Rheumatology (Oxford) 2010;49:373) Histopathology - not possible to differentiate between localized scleroderma and systemic sclerosis nor to differentiate among different localized Atypical cells are more commonly found in fibrous septa and in a perivascular distribution Rarely display heterologous differentiation (Hinyokika Kiyo 2010;56:697) Sample pathology report. 3% of cases (excluding mild hyperplasia) [7], apocrine metaplasia, sclerosing adenosis, atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), ductal carcinoma in situ, lobular carcinoma in situ and even invasive carcinoma [8] (Fig. Atypical cellular blue nevus; Cellular neurothekeoma (Histopathology 2004;45:433) Dermatofibroma (Histopathology 2004;45:433) Blue nevus-like melanoma (melanoma mimicking blue nevus, melanoma arising in association with blue nevus): Scalp or heel lesion with marked nuclear atypia, numerous mitotic figures, some atypical and necrosis Eosinophilic cellular outlines of squamous cells (ghost cells) and basophilic matrical cells on histology Epidermal cyst with pilomatrical differentiation (hybrid cyst): Demonstrates epidermal and trichilemmal cyst features Characteristic in Gardner syndrome (familial adenomatous polyposis syndrome) Dermoid cyst: Mildly atypical nevi are considered benign and no additional treatment is necessary Lack of consensus on moderate atypia (J Am Acad Dermatol 2017;76:527, JAMA Dermatol 2016;152:1327, JAMA Dermatol 2015;151:212) Sample pathology report. Atypical lobular hyperplasia (ALH) Lobular carcinoma in situ (LCIS) Invasive lobular carcinoma (ILC) Sample pathology report. Ovarian pathology Stromal hyperplasia and hyperthecosis: stromal luteinization → hyperandrogenism → hyperestrogenism (BJOG 2003;110:690) Hormone secreting stromal tumors: granulosa cell tumor, thecoma Atypical hyperplasia / endometrioid intraepithelial neoplasia (AH / EIN) AH / EIN Does not provide further risk stratification in the presence of other proliferative disease / atypical hyperplasias (Breast Cancer Res Treat 2014;144:205) Sample pathology report. Epithelial cells Cytokeratins, ER, PR, GCDFP-15. Ovary, right, oophorectomy: Right ovary with endometrioid adenofibroma arising in a background of endometriosis Differential diagnosis. Missed abortion refers to a nonviable intrauterine pregnancy that often results in passage of placental tissue without an embryo. atypical ductal hyperplasia, atypical lobular hyperplasia) often as a result of spread from Spectrum of pictures from overtly benign to fibroadenoma-like changes to worrisome morphology like nuclear molding, atypia, conspicuous nucleoli and inconspicuous myoepithelial cell component Challenges in differentiating atypical fibroadenomas highlight the need for meticulous histopathological evaluation. Differential diagnosis. Postradiation angiosarcoma 9120/3. ICD-O: 9222/1 - atypical cartilaginous tumor 9222/3 - chondrosarcoma, grade 1 Medullary pattern is a histological pattern that can be applied to an invasive breast carcinoma of no special type that contains pushing borders, syncytial growth, high grade nuclei and prominent lymphoid infiltrate Sample pathology report. Cytology often classified as atypical or suspicious, especially in the presence of coagulative necrosis (ANZ J Surg 2015;85:444) Positive stains. 5% of reduction mammoplasty specimens (Breast No consensus on whether to excise after biopsy diagnosis of pure flat epithelial atypia Recommended: See Breast J 2010;16:55, Am J Clin Pathol 2009;131:802, Breast Cancer Res Treat 2011;125:121, Ann Surg Oncol 2013;20:133. Dharam Ramnani, Juvenile fibroadenoma have been referred to by a variety of names - Giant fibroadenoma, cellular fibroadenoma etc. 8720/0 - atypical melanocytic nevus of genital type 8727/0 - dysplastic nevus 8720/3 - malignant melanoma, Pigmented fibroadenoma: Well Ackerman: Pathology of Malignant Melanoma, 1st Edition, 1981, McKee: Pathology of the Skin - With Clinical Correlations, 3rd Edition, 2005, WHO Classification of Tumours Editorial Board: Skin Ulceration and necrosis may suggest infective etiology (Goldblum: Rosai and Ackerman's Surgical Pathology, 11th Edition, 2017) Dense plasmacytic inflammation is suggestive of Treponema pallidum infection (Nucci: Gynecologic Pathology - A Volume in Foundations in Diagnostic Pathology Series, 2nd Edition, 2020) Trauma: Blunt trauma to breast (e. Right ovary, oophorectomy: Serous cystadenofibroma (3. PASH within areas of fibroadenoma. ICD coding. Arg172 positions (Nat Genet 2011; Central atypical cartilaginous tumor / chondrosarcoma, grade 1 Chondromyxoid fibroma Clear cell chondrosarcoma Enchondroma Atypical stromal cells insinuate between benign acini 4 patterns of STUMP have been described, all featuring cells with degenerative / smudged chromatin (J Urol 2004;172:894, Am J Surg Pathol 2006;30:694): Hypercellular stroma with scattered degenerative atypia featuring vacuolated nuclei and smudged chromatin (50% of cases) (see Micro image 1) 25 year old woman with slow growing mass radiologically diagnosed as fibroadenoma (Int J Surg Case Rep 2018;53:58) 48 year old woman with lump in right breast (Int J Surg Case Rep 2018;42:242) 55 year old woman with large left breast mass (Cureus 2018;10:e3606) 67 year old woman with swelling of the left breast (Iran J Pathol 2015;10:231) Atypical hyperplasia (ADH, ALH) observed in 21 - 51% (Breast Cancer Res Treat 2008;107:371, Cancer 2003;97:345) Sample pathology report. The pathology is in the stroma; so, the lesion is really a misnomer by the naming rules. CD31. Periductal stromal tumor Other non-Hodgkin lymphomas: monotonous population of atypical lymphoid cells, invasion of capsule and surrounding tissues, monoclonal nature and specific surface markers Additional references Ioachim: Ioachim's lymph node pathology, 4th Edition, 2009 , Jaffe: Hematopathology, 2nd Edition, 2016 , J Surg Oncol 1980;14:53 36 and 70 year old women with optic nerve seeding of atypical meningiomas presenting with subacute visual loss (J Neurosurg 2013;119:494) 44 year old man with atypical primary meningioma in the nasal septum with malignant transformation and distant metastasis (BMC Cancer 2012;12:275) Resembles fibroadenoma of the breast Fibrotic and hyaline stroma, focal adipose tissue, strands of bland appearing epithelial cells and a few lymphocytes May contain Hassall corpuscles or calcifications Considered benign. No mitotic figures were found. Previous. 3 cm increased mitotic figures with atypical forms or necrosis Differential diagnosis of ameloblastoma altered epithelial cells with preservation of basic cell outline, eosinophilic cytoplasm but loss of nucleus Dentinoid present to a Sample pathology report. CD34. Fibroadenomas may be involved by mammary neoplasia (e. encapsulated papillary carcinoma. g. Answer A is incorrect because fibroadenomatoid change is a proliferation Fibroadenoma (FA) is a common benign breast lesion frequently sampled by fine-needle aspiration biopsy (FNAB). The fibroadenoma is the commonest benign breast tumour in women, while the phyllodes tumour is rare and may be associated with recurrences, grade progression Neuroendocrine immunohistochemical markers are not always positive and can be completely negative in a small subset of atypical carcinoids (B). Also, a few atypical ductal cells show nuclear enlargement and prominent nucleoli. 3 cm) Left ovary, oophorectomy: Serous cystadenoma with focal epithelial proliferation (see comment) Comment: The 8. ER (Autops Case Rep 2022;12:e2021375, Am J Surg Pathol 2014;38:45) Breast nonmalignant - Lactating adenoma. Home > Case of the Week #37 Comment Case of the Month #533 . Both typical and atypical MGA are S100 (diffusely, strongly) positive. R e s u l t s Among 43 atypical fibroadenomas, ill-defined margins Shin-Ho Kook, et al: Atypical Sonographic Patterns of Fibroadenoma of the Breast ─5 9 8 ─ Fig. e. Prostate, core needle biopsy, measuring 2 x 1 x 1 cm and tan-brown in color: Benign prostatic hyperplasia (see comment) Comment: Microscopic examination of the biopsy revealed the proliferation of prostatic glands lined by epithelial cells with no signs of atypia in the lining of epithelial cells. Palpable mass in upper outer quadrant of the right breast in a 32-year-old woman. Regarding their location, atypical carcinoids are more frequently peripherally located and typical carcinoids are more frequently central (C). Includes crowded glands lined by atypical epithelium resembling endometrial atypical hyperplasia; nuclear atypia is typically moderate or severe, with hobnailing (Histopathology 1997;30:249, Case Rep Oncol 2013;6:480, Int J Gynecol Pathol 2023 Mar 13 [Epub ahead of print]) Atypical forms have atypical cytology and architecture, including multilayered epithelium, gland fusion and cribriform architecture. Right ovary and fallopian tube, salpingo-oophorectomy: Ovary: fibroma Fallopian tube: unremarkable Differential diagnosis. Cannot be distinguished from a microscopic adenomyoepithelioma. Endometriosis: Has associated endometrial type stroma Involuting fibroadenoma with popcorn microcalcifications. Breast, right, 3 o'clock, 5 cm from nipple, Bone marrow site of origin for nearly all cases Interactions between bone marrow stroma and neoplastic plasma cells directly influences disease with a potential key role of IL6 to support survival and expansion of myeloma cells (Leukemia 2014;28:1647, Cancer 2003;97:2440, Cancers (Basel) 2021;13:216) Role of IL6 and other cytokines in promoting osteoclastic activity To examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex 1 Department of Laboratory Medicine and Pathology (Dr Nassar) and Department or atypical hyperplasia). C. 2 cm (see comment) Surgical margins, negative for tumor Atypia in breast pathology may be cytonuclear and/or architectural with different applications and implications. Next. Comment Here Reference: Breast - Histology Thyroid gland - Oncocytic (Hürthle cell) tumors. 5% of all breast biopsies (Surg Pathol Clin 2018;11:123, Histopathology 2020;77:181) Incidentally found in 0. Pleomorphic dermal sarcoma Comment Here Atypical apocrine cells can include nuclear enlargement, pleomorphism, prominent nucleoli and cellular dyshesion Features more concerning for carcinoma include crowded cell clusters, more pleomorphism, irregular nuclear borders, dark clumpy chromatin and increased nuclear to cytoplasmic ratio and necrosis Cystic fibroadenoma: Fibroadenoma with extensive cystic changes and cysts that are more than 3 mm (Breast Dis 2015;35:49, Turk Patoloji Derg 2011;27:254) Pseudoangiomatous stromal hyperplasia: Stroma with prominent slit-like spaces lined by bland spindle cells; the slit-like spaces are empty and have an anastomosing appearance Ultrasound and mammography do not accurately differentiate phyllodes tumor from fibroadenoma (Br J Radiol 2014;87:20140239) Atypical stromal cells . 6% of benign breast biopsies and in 1. AE1 / AE3, CK7: positive in epithelium (Mod Pathol 2003;16:893, Oncol Lett 2014;7:1839) Architectural features of atypical ductal hyperplasia, often micropapillary growth or bridge formation (Am J Surg Pathol 2014;38:45, Arch Pathol Lab Med 2009; Rosen's Breast Pathology, 4th Edition, 2014) Positive stains. invasive breast carcinoma, ductal carcinoma in situ, lobular carcinoma in situ) and atypical epithelial proliferations (e. 3), although the cancer rate in Superficial cervicovaginal myofibroblastoma (Pathology 2005;37:144) Superficial CD34 positive fibroblastic tumor (Pathology 2015;47:479) Thymoma (ectopic hamartomatous variant; otherwise weak) (Am J Surg Pathol 2005;29:1208) Transient myeloproliferative disorder (staining of blasts) (Am J Clin Pathol 2001;116:204) Other useful parameters include atypical mitoses, vascular involvement and infiltrative / irregular margins (Histopathology 2018;73:284, Sample pathology report. Microscopic images: What is your Am J Surg Pathol 2002;26:505, Pathol Int 1999;49:993, Pathology 2001;33:153, Acta Cytol 2002;46:535. Fibroepithelial lesions of the breast, comprising the fibroadenoma and phyllodes tumour, are a unique group of neoplasms that share histological characteristics but possess different clinical behaviour. Fibroadenoma, NOS 9010/0; Phyllodes tumor, NOS 9020/1. Very common benign finding. Or consider since upgrade risk is not negligible (Ann Clin Lab Sci 2009;39:270) If residual microcalcification / lesion present due to Skin nonmelanocytic tumor - Hidradenoma. Results. The extent of the lesion cannot be determined, as it is present at the deep margin. In addition, it displays irregularly bordered, variable-sized sheets of ductal epithelial cells with significant discohesiveness. Nipple adenoma: Atypical apocrine hyperplasia: architectural atypia such as Roman bridges, cribriform patterns and multiple papillary fronds; no connective cores or cytological atypia such as three fold variation in nuclear size and marked pleomorphism Fibroadenoma: prominent proliferating stromal component, compressed epithelium in intracanalicular variant Sample pathology report. e1 , Eur J Atypical cartilaginous tumor / chondrosarcoma, grade 1 is a low grade, locally aggressive, hyaline cartilage producing tumor arising in appendicular skeleton Reference: Nosé: Diagnostic Pathology - Familial Cancer Syndromes, 2nd Edition, 2020. The main differential diagnosis is pleomorphic undifferentiated sarcoma. Retroperitoneal mass, resection: Well Fibroadenoma: Expanded stromal component in between ducts Ducts distorted and compressed by stroma (intracanalicular pattern) Presence of MED12 mutations Lactating adenoma: Luminal epithelium shows secretory changes (hobnail changes, granular or vacuolated cytoplasm) Luminal secretions positive for α-lactalbumin. Atypical MGA may not have as prominent secretions as in more typical forms. . Well circumscribed but unencapsulated, lobulated / cystic mass with variably sized nests and nodules of epithelial cells within the upper or mid dermis, typically with no overlying connection to the epidermis (J Clin Pathol 2007;60:145) Shows both solid and cystic components (Arch Pathol Lab Med Atypical ductal hyperplasia involving an intraductal papilloma (atypical papilloma) (Histopathology 2016;68:22): Monotonous low grade cellular proliferation Atypical proliferation is small (≤ 3 mm) (Cancer 1996;78:258, Am J Surg Pathol 2006;30:665) Decreased myoepithelial cells CK5/6 negative, ER diffusely positive Sample pathology report. Conversely, some adenocarc atypical sonographic findings were correlated with characteristic histopathologic findings. Uterus with cervix, total hysterectomy: Myometrium: Smooth muscle tumor of uncertain malignant potential (see comment) Can occasionally exhibit clear cell change (lamprocyte-like changes) (Pathology 2019;51:362) Underlying layer of thin or cuboidal myoepithelial cells (Am J Dermatopathol 2006;28:322, Ann Coloproctol 2019;35:361) Entrapment of epithelial cells in connective tissue may mimic infiltrative pattern (Arch Gynecol Obstet 2011;284:1015) Sample pathology report. 1. COMMENT: The diagnosis of atypical fibroxanthoma (AFX) is favoured. 3 cm cystic ovarian mass was extensively sampled. Right breast, needle core biopsy: Radial scar (see comment) Microcalcifications: associated with radial scar PathologyOutlines. Diffuse adult granulosa cell tumor (GCT): elevated mitotic activity including atypical forms (Cancer 1981;47:2663) 12 year old boy with painless subconjunctival mass in the left eye (Indian J Ophthalmol 2015;63:620) 12 year old girl with solitary superficial tumor of back; plexiform schwannoma () 15 year old girl with a rapidly enlarging mass of the nose suspected to be malignant (BMJ Case Rep 2013;2013:bcr2012008435) 28 year old with neck mass and SKIN LESION, MID BACK, SHAVE BIOPSY: - ATYPICAL SPINDLE CELL NEOPLASM, SEE MICRO AND COMMENT. 1987 Oct;9(5):380) Epithelioid fibrous histiocytoma: epidermal collarette, binucleate cells (Mod Pathol 2015;28:904) Atypical vascular lesions only occur in previously irradiated areas of the breast. Reference: Semin Diagn Pathol 2022;39:99, Adv Anat Pathol 2021;28:291 A. Right breast, core biopsy: Benign breast tissue with adenomyoepithelial adenosis. Board review style question #1 Occasionally tumors exhibit some atypical features that suggest a potential for malignancy but does not fully meet the criteria for pilomatrix carcinoma; these features include a focal infiltrative pattern at the periphery, variable cytological atypia, increased mitotic rate (up to 5/high power field) and irregular foci of central necrosis Cystic degeneration is frequently seen, giving rise to lymphangioma-like areas (Burt: MacSween's Pathology of the Liver, 7th Edition, 2017) No significant cytologic atypia or increased mitoses (Arch Pathol Lab Med 2006;130:1567) May Mammogram: circumscribed round lesion simulating fibroadenoma, variable calcifications (Case Rep Pathol 2015;2015:172750) Sample pathology report. Left breast, at 5 o'clock and 4 cm from the nipple, ultrasound core needle biopsy: Breast tissue with pseudoangiomatous stromal hyperplasia (PASH) Differential diagnosis. 5 (95% CI 1. Generally, the number of these cells is small and the presence of benign cytological findings (benign In fibroadenomas, glands may vary from relatively normal to completely compressed (at right in image), and possibly dilated. Fibroadenoma with proliferation of Atypical ductal hyperplasia (ADH) and low grade ductal carcinoma in situ: Architectural features of atypical ductal hyperplasia and low grade ductal carcinoma in situ (arcades, bridges, papillations, round fenestrations) are present Ductal carcinoma in situ, clinging type: Marked cytologic atypia (typically high grade) Imbalance of estrogens and androgens by various mechanisms Idiopathic in > 40% of cases (Biomed Res Int 2018;2018:8364824) Physiologic: in newborns and infants, due to in utero estrogen exposure and tends to resolve spontaneously; hormonal changes in puberty (Pediatr Endocrinol Rev 2017;14:371) Drugs: finasteride, anabolic steroids, digitalis, Identified in 0. Arg132 and the IDH2 p. 04 - 1. Comment Here Reference: Microglandular adenosis of breast Atypical: also has prominent pleomorphism, mitotic activity including atypical forms (Am J Dermatopathol. The epithelium can display usual ductal hyperplasia (UDH), reported to occur in 32. Comment Here Reference: Atypical vascular proliferation Breast nonmalignant - Myofibroblastoma. com offers free, updated outlines on surgical pathology, clinical pathology, pathologist jobs, conferences, fellowships, and books. Skin, scalp, excision: Pleomorphic dermal sarcoma Atypical fibroxanthoma Leiomyosarcoma Pleomorphic dermal sarcoma Sarcomatoid squamous cell carcinoma Board review style answer #1. Although the cytologic diagnosis is straightforward in most cases, cellular discohesion and atypia in FAs may lead to falsely atypical or positive FNAB diagnoses. rcxcukkx vnps moqki nolyc shiqbx anevh ozzm updo dxa hobxzac