| 图片： | |
|---|---|
| 名称： | |
| 描述： | |
- B2230不典型小叶增生累及乳头状瘤(cqz-27)
F1, E-cadherin
F2. P-120
F3. dual stain 200x
F4. dual stain 400x
So it is atypical lobular hyperplasia involving papilloma. I signed out this case as atypical papilloma with comment.
Important points for this case:
1. ALH can involve many different lesions, such as sclerosing adenosis, fibroadenoma, radial scar, papilloma......
2. Atypical papilloma can have different meaning.
1. It is 残存导管.
2. It is difficult to separate LCIS from ALH for some cases even though there are good calssification or definition. For this case it is ALH not LCIS
3. Lobular neoplasia (ALH and LCIS) is only an indicator of the risk for more severe lesions. In the USA most people think if lobular neoplasia is present in the core bx, the patients should have excisional biopsy.
No need to treat lobular neoplasia.
Most netfriends are interested to the cancer cases, but not some uncertained cases.
Thank 青青子矜 for above reasonable analysis. Based on her instruction, I paste here dual IHC for p120 and E-cadherin for the lesions (floor 29), areas close to the large papilloma.
Recently I am very busy with other things. Sorry I did not follow up this case on time. Anyway I will continue to work with your guys for this case.
1. 腺肌上皮瘤 is a differential dx. However the IHC did not support the dx
2. Now most of people think it is introductal papilloma. It is true it is introductal papilloma.
3. I would not show you a classic introductal papilloma case. So it must have some other lession related to the papilloma. Please check the photos more carefully, especially in high power.
4. In order to make it easy for you. I will paste some photos with areas close to the papilloma.
Interested to ses above differential dx. This is a consult case. The primary pathologist (from a local hospital) thought it maight be a DCIS (papillary type). Some general pathologists in the usa are not good////.
One of our breast path fellow reviewed the case and thought it may be denomyoepithelioma as most of you.
-
本帖最后由 于 2009-09-05 06:52:00 编辑
Lunch time, Check this caes. Thank Dr. Wang's translation. Now there are a lot of pathologists with high level of English in China. This is a good sign.
似纤毛又非似纤毛: these kinds of structures are very common in columnar cell changes, papilloma, FCC et al. You will notice them often when you pay attention to. Forget these structures. They are not important for the dx of this case.
Accepted Dr. 197's suggestion. I am sending the larger photos. My microscope and camera are new and cost almost US$25,000. However I seldom took good photos. There are too many function I never know.
Humans are more important than eqiupments. Mao once said that victory of a war depends on humans, but not the weapons.
Ok, I need to start to read my today's breast cases now.
