Breast core biopsy with 8 cores. There are multiple breast lesions. Try you diagnosis one by one.

Lesion 1 20x and 400x

 Lesion 2

fig 100x and 200x

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描述：图1

名称：图2
描述：图2

 Lesion 4

40x and 100x

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描述：图1

名称：图2
描述：图2

 Lesion 5

400x

There are two different diagnosis in this area

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描述：图1

 Lesion 6

40x and 100x

名称：图1
描述：图1

名称：图2
描述：图2

 Lesion 7

Fig 1 100x

Fig 2-5 200x

Fig 6 400x

Hope you can appreciate three diagnoses (or three terms) in this focal area.

名称：图1
描述：图1

名称：图2
描述：图2

名称：图3
描述：图3

名称：图4
描述：图4

名称：图5
描述：图5

名称：图6
描述：图6

 Breast pathology is complicated. We as pathologists need to recognize the cancers and all other borderline or benign lesions. There are several lesions in this breast core specimen. Please make your dx based on above orders, lesion 1, 2, 3,....

Thanks,

cz

 均为良性病变

1.鉴别小叶病变与导管上皮增生

2.大汗腺化生

3.导管囊性扩张伴分泌物储留

4.腺病

5.柱状细胞病变

6.纤维囊性乳腺病

7.腺病，上皮分泌，导管上皮普通型增生

 To Dr. cici,

Please read more carefully.

 此病变有以下特征：

1 导管上皮增生，伴有轻-中度非典型增生

2 导管上皮乳头状增生，伴大汗腺化生

3 导管囊性扩张伴分泌物潴留

4 导管内乳头状瘤

5 ？是导管良性病变

6  纤维囊性乳腺病

7  腺病，导管上皮增生，伴中度非典型增生。

新手上路，望各位老师多多指教。 

 Dr. Zhao,

Thank you very much for sharing interesting case and beautiful pictures. It's very nice to learn your cases. I am too tired. I wil come back tomorrow.

 1,小叶瘤变（LN） vs DCIS累及小叶

2，有些说不准，因为细胞像大汗腺化生，但似乎在腔内有tuft 或纤维芯，是否为乳头状瘤或低级别DCIS

3，是囊肿（cyst），上皮是否有柱状细胞病变，有待去办公室翻书

4，导管内乳头状瘤，伴硬化

5，低级别LN

6，是腺病

7，低级别DCIS，伴柱状上皮病变

Waiting for the explanaiton of Dr.Zhao.Thanks for sharing the challenging case.

 腺病,局部区域腺上皮轻~中度非典型増生.

11楼说的中听.

以下是引用luolili在2009-2-18 14:22:00的发言：

 此病变有以下特征：

1 导管上皮增生，伴有轻-中度非典型增生

2 导管上皮乳头状增生，伴大汗腺化生

3 导管囊性扩张伴分泌物潴留

4 导管内乳头状瘤

5 ？是导管良性病变

6  纤维囊性乳腺病

7  腺病，导管上皮增生，伴中度非典型增生。

新手上路，望各位老师多多指教。 

 i'm back again.

1 小叶瘤变（经典型）

2 低级别导管内原位癌（微乳头型）

3 导管扩张伴分泌物潴留

4 导管内乳头状瘤

5 平坦型上皮不典型性

6 硬化性腺病伴大汗腺化生

7 普通导管增生，非典型导管增生，低级别导管内原位癌

望老师多多指教！

1. Lobular carcinoma in situ.

2.atypical duct hyperplasia, papillary variant.

3.dilated duct.

4. papilloma.

5.columnar cell change

6.sclerosing adenosis

7.columnar cell lesions including columnar cell change, columnar cell hyperplasia,flat epithelial atypia(atypical duct hyperplasia?)

 Quickly review all of your interpretation. Most of them are reasonable. In this topic I will concentrate for the interpretaion of FEA, columnar cell change. If you are interested you can review the text book or related articles for some photos first. Then we can have some discussion together. Dr. Stuart, J. Schnitt from Beth Israel Deaconess Medical Center, Harward Medical School, Boston, MA did a lot of study in this area. In fact he raised some terms. Frequently speaking, I am often confused by the diagnosis of FEA in my clinical practice.

Hope more people share the diagnosis about my first 7 lesions from the same patient.

Thanks,

cz

 To 漫游人,

Welcome you join our discussion and share your experience. I saw your discussion for one of my gynecologic case. Very good interpretation for the rare ovarian tumor. Thanks, cz