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- Breast lobular lesions and stains ( cqz 7)
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The same as most of you I first considered it was lobular carcinoma in situ in this core biopsy specimen. However, IHC results indicated it was a not lobular lesion. Now we know there are three possibilities, normal hyperplasia, ADH, and DCIS. Seeing the H&E slides more carefully, we know it is definitely abnormal. Generally the morphologic features of ADH are not like this. So only one possibility is DCIS with lobular extension or DCIS involving acini of lobules. If the specimens contain DCIS and DCIS with lobular extension, it is relatively easy to recongnize. If only lobular extension of DCIS is present in the specimen, it is difficult to make the diagnosis. But we should consider the possibility. Most of you did not consider the diagnosis. The reasons are you only see the photos, not true slides. Also the photos are not in the high power.
I reported lobular extension of intraductal carcinoma. The women had segmental mastectomy. The mastectomy specimen showed the DCIS closely to the previous core biopsy area.
This is for this case. Thanks.
I want to complete this topic. I showed you five cases here. I hope you understand the following
1. Diagnosis of lobular lesion is important.
2. Lobular lesions, especially ALH are easy to be ignorred.
3. Sometimes dx of lobular lesions are very difficult.
4. Lobular lesions can be misdiagnosed as ductal lesions and ductal lesions can be misdiagnosed as lobular lesions too.
5. If you are not sure, please do IHC. In fact now we do IHC for most lobular lesions. Often we can see the unexpected results.
6. E-cadherin and P120 are the best antibodies for lobular lesions.
Now it is close to Chinese New Year. Hope every one has a nice New Year Holiday. I have to work on Monday, the first day of the year. The Eve of New year I will invite some of my friends in my home for a party. We can see the CCTV New Year celeberation also.
I will be very glad if the topic can provide you some information and can give some help in your clinical practice.
Thank all of you for reading and discussing this topic.
cz
| 以下是引用cqzhao在2009-1-25 0:09:00的发言：
The same as most of you I first considered it was lobular carcinoma in situ in this core biopsy specimen. However, IHC ...... This is for this case. Thanks. |
谢谢赵老师！大致翻译如下：
和多数观点一样，在这个粗针活检标本上我首先认为这是小叶原位癌。然而，免疫组织化学结果表明它不是一个小叶病变。现在我们知道有三种可能性，正常增生，ADH和DCIS。更仔细地看到了HE幻灯片，我们知道这肯定是不正常的。一般来说，ADH的形态特征不是这样。因此，只有一种可能是沿小叶蔓延DCIS或DCIS涉及小叶的腺泡。如果标本中有DCIS和DCIS蔓延至小叶，这是比较容易判断的。如果现在标本中只有DCIS延及小叶，，这是很难做出诊断。但是，我们应该考虑是否有可能。大都没有考虑诊断，原因是你只看到照片，而不是真正的切片。这些照片也不是高倍。
我报告为：DCIS蔓延至小叶。这个妇女做了区段性切除。手术标本显示的DCIS与此前的粗针活检区域接近。
这是此例的情况。谢谢。
我报告为：DCIS蔓延至小叶。这个妇女做了区段性切除。手术标本显示的DCIS与此前的粗针活检区域接近。
这是此例的情况。谢谢。
- 广州金域病理
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本帖最后由 于 2009-01-28 14:52:00 编辑
| 以下是引用cqzhao在2009-1-25 0:28:00的发言：
I want to complete this topic. I showed you five cases here. I hope you understand the following 1. Diagnosis of lobular lesion is important. ...... |
谢谢！大致翻译如下：
我想完成这个课题。我在这里展示五个病例，希望你理解以下
1 。小叶病变的诊断是非常重要的。
2 。小叶病变，特别是ALH容易被忽略 。
3 。有时小叶病变的诊断是非常困难的。
4 。小叶病变可误诊为乳腺导管病变和导管病变也可被误诊为小叶病变。
5 。如果您不能确定，请做IHC。事实上，现在我们做免疫组化最多的是小叶病变。我们常常可以看到意想不到的结果。
6 。 E - cadherin和P120是标记小叶病变最好的抗体。
现在是接近农历新年。希望大家有个很好上的新年假期。我要工作，星期一的第一天是新年的前夕，我将邀请我的一些朋友在我家开Party。我们可以看到中央电视台新年庆祝。
如果这个专题可以为您提供一些信息，提供一些帮助和临床实践，我将非常高兴。
感谢所有的阅读和讨论这个话题的朋友们。
1 。小叶病变的诊断是非常重要的。
2 。小叶病变，特别是ALH容易被忽略 。
3 。有时小叶病变的诊断是非常困难的。
4 。小叶病变可误诊为乳腺导管病变和导管病变也可被误诊为小叶病变。
5 。如果您不能确定，请做IHC。事实上，现在我们做免疫组化最多的是小叶病变。我们常常可以看到意想不到的结果。
6 。 E - cadherin和P120是标记小叶病变最好的抗体。
现在是接近农历新年。希望大家有个很好上的新年假期。我要工作，星期一的第一天是新年的前夕，我将邀请我的一些朋友在我家开Party。我们可以看到中央电视台新年庆祝。
如果这个专题可以为您提供一些信息，提供一些帮助和临床实践，我将非常高兴。
感谢所有的阅读和讨论这个话题的朋友们。
- 广州金域病理
