1/94. Diagnosing invasive cystic hypersecretory duct carcinoma of the breast with fine needle aspiration cytology. A case report.BACKGROUND: Cystic hypersecretory duct carcinoma (CHC) of the breast, first described in 1984, is a rare variant of duct carcinoma. Histologically it is characterized by the formation of dilated ducts and cysts containing an eosinophilic secretory product resembling thyroid colloid. The lining epithelium of the cysts atypically proliferates to form intraductal carcinoma. Only four cases of invasive cystic hypersecretory carcinoma have been reported. CASE: We present a case of invasive CHC with tumor emboli in many lymphatic spaces and axillary nodal metastases. The lesion was also evaluated by fine needle aspiration. Direct smears with Papanicolaou stain were highly cellular and had abundant, intensely staining, orange-to-gray-green thyroid colloid-like material. epithelial cells, showing a variety of cellular patterns, were indistinguishable from usual ductal carcinoma cells. These cytologic findings may be characteristic enough to suggest cystic hypersecretory carcinoma. CONCLUSION: The cytologic features of CHC are distinctive and correlate with histology. This was the first presentation of colloidlike secretory material in cytologic material with Papanicolaou stain in such a case. Invasive CHC tends to have aggressive behavior. Cystic hypersecretory hyperplasia coexisted in this case.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
2/94. The potential oncogenic effect of tamoxifen on the endometrium.We report the case of an in-situ endometrial adenocarcinoma with severe atypical hyperplasia which developed while the patient was on tamoxifen only 1 year after endometrial resection for benign pathology. A 55-year-old woman received tamoxifen as adjuvant therapy for breast cancer treated in 1994. At that time, a benign endometrial polyp was also removed before initiating tamoxifen treatment. In 1997, endometrial resection was performed for benign pathology (atrophic cystic endometrium). In 1998, an endometrial adenocarcinoma was diagnosed. This case illustrates that endometrial resection does not protect women taking tamoxifen against subsequent development of severe atypical lesions.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
3/94. Uterine pleomorphic rhabdomyosarcoma in a patient receiving tamoxifen therapy.INTRODUCTION: tamoxifen has been used as adjuvant therapy for the treatment of breast cancer. Its use has been associated with the development of proliferative endometrial lesions such as polyps, hyperplasia, and carcinoma. Mesenchymal tumors including malignant mixed mullerian tumors, endometrial stromal sarcomas, adenosarcomas, and leiomyosarcomas have been more recently described with tamoxifen use. CASE REPORT: This report describes the first case of a pure uterine rhabdomyosarcoma in a patient receiving tamoxifen therapy. DISCUSSION: Although uterine rhabdomyosarcomas are rare tumors and may arise de novo, we discuss the possible role of tamoxifen in the development of these mesenchymal tumors.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
4/94. Malignant adenomyoepithelioma of the breast with malignant proliferation of epithelial and myoepithelial elements: a case report and review of the literature.Malignant adenomyoepithelioma of the breast is a rare lesion characterized by malignant proliferation of epithelial and myoepithelial cells that show characteristic histologic and immunohistochemical features. Eleven cases have been reported, 4 of which showed evidence of distant metastasis. The authors report a case of malignant adenomyoepithelioma in the axillary tail of a 71-year-old woman, one of the oldest patients described so far, and review the literature. Malignancy in the current case was evidenced by the presence of local invasion, high mitotic rate, and severe cytologic atypia. The tumor was associated with adenosis and lobular adenomyoepithelial hyperplasia. Malignant adenomyoepithelioma is a rare neoplasm, diagnosable by light microscopy and immunohistochemistry. To date, it has only been reported in women, who ranged in age from 26 to 76 years. Metastases have only been documented in tumors 2.0 cm in diameter or larger.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
5/94. Atypical medullary carcinoma of the breast with cartilaginous metaplasia in a patient with a BRCA1 germline mutation.We examined a 34-year-old premenopausal woman who had noticed a left-breast lump a month previously. She had no past history of malignancies but had a family history of breast and ovarian cancers. Her mother had suffered from ovarian cancer when aged 47 years and had died of the disease at age 52. The younger two of the patient's four aunts had developed breast cancer when they were 37 and 48 years old. A physical examination showed an ill-defined mass, 1.5 cm in diameter, located in the upper outer quadrant of the patient's left breast. mammography revealed diffuse microcalcification in both breasts but ultrasonography revealed an irregular tumorous lesion only in the left breast. Aspiration breast cytology revealed adenocarcinoma of the left breast. Modified radical mastectomy of the left breast and excision of a biopsy specimen from the right breast were carried out simultaneously. Histopathologically the left-breast tumor was an atypical medullary carcinoma with cartilaginous metaplasia, of histological grade 3, and the right-breast specimen showed fibrocystic changes with atypical ductal hyperplasia. Estrogen receptors were positive, but progesterone receptor was not detected on the tumor cells, which were immunopositive for nuclear p53 although c-erbB-2 overexpression was not observed. A nonsense germline mutation of the BRCA1 gene (exon5) was detected. The patient has been well since the operation (10 months). These findings may provide useful information about the carcinogenesis and biological behavior of BRCA1-associated breast cancers.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
6/94. Primary bilateral mucosa-associated lymphoid tissue lymphoma of the breast with atypical ductal hyperplasia and localized amyloidosis. A case report and review of the literature.Primary non-Hodgkin lymphoma of the breast is a rare disease. Primary mucosa-associated lymphoid tissue lymphoma is even rarer, and bilateral involvement is exceptional. We describe a case of primary bilateral breast mucosa-associated lymphoid tissue lymphoma with bilateral atypical ductal hyperplasia and bilateral localized amyloidosis in a 64-year-old woman with a history of arthritis and systemic lupus erythematosus and its clinical, histologic, and immunohistochemical features. Microscopic examination of the breast lesion showed dense periductal and perilobular small and plasmacytoid lymphocytes with eosinophilic amyloid in the vessels and the stroma. Bilateral single foci of atypical ductal hyperplasia were also noted. Fine needle aspiration showed small and large lymphocytes and plasma cells. Molecular analysis demonstrated a heavy chain immunoglobulin H gene rearrangement. flow cytometry studies showed an abnormal B-cell population. The combined histologic, paraffin immunohistochemistry, flow cytometry, and molecular results were considered diagnostic for low-grade mucosa-associated lymphoid tissue lymphoma. The patient underwent bilateral local breast radiation without other organ or site involvement.- - - - - - - - - - ranking = 6keywords = hyperplasia (Clic here for more details about this article) |
7/94. Endometrial metastasis from breast cancer in a patient receiving tamoxifen therapy.tamoxifen (TAM) is known to be associated with several types of endometrial pathologies, e.g. hyperplasias, polyps and endometrial carcinomas, sometimes of special histologic type. Here we report a rare case of endometrial metastasis from a breast carcinoma (ductal carcinoma) discovered during TAM therapy. This occurrence does not suggest that TAM treatment causes endometrial metastases of breast cancer. However, clinicians should be aware of this possibility and provide patients receiving TAM therapy with close gynecologic follow-up using liberal indications for endometrial biopsies.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
8/94. Pseudoangiomatous hyperplasia of mammary stroma: a case of pure type after removal of fibroadenoma.A case of pure pseudoangiomatous hyperplasia of the mammary stroma after removal of a fibroadenoma is described. The lesion, which was found in the right breast of a 40-year-old woman, was a well-circumscribed non-encapsulated, rubbery, lobulated mass measuring 40x40x35 mm. Histologically, it consisted predominantly of a proliferation of spindle cells with interanastomosing vascular-like arrangements in the interlobular or interductal stroma. Neither cytological atypia nor mitotic figures were observed. The stroma contained abundant collagen with focal hyalinization. Focally, epithelial elements showed mild ductal hyperplasia. There was no fibroadenoma. Immunohistochemically, the spindle cells were positive for vimentin, CD34, alpha-smooth muscle actin, muscle actin, CD34, calponin, and progesterone receptors. Ultrastructurally, many spindle cells had thin elongated cytoplasmic processes, which enveloped pseudovascular spaces containing a few collagenous fibrils, indicating fibroblastic cells. This lesion should be distinguished from other mammary fibrous and vascular lesions with which it may be confused.- - - - - - - - - - ranking = 6keywords = hyperplasia (Clic here for more details about this article) |
9/94. gynecomastia in type-1 neurofibromatosis with features of pseudoangiomatous stromal hyperplasia with giant cells. Report of two cases.We describe the histological finding in two cases of gynecomastia in patients with von Recklinghausen's disease. The histological and immunohistochemical features of the two cases were reviewed and compared with those of five cases of gynecomastia in men without clinical evidence of neurofibromatosis. In both patients bearing von Recklinghausen's disease, the breast stroma showed features consistent with pseudoangiomatous stromal hyperplasia (PASH). It was characterised by anastomosing empty spaces lined by spindle and multinucleated giant cells which were positive with CD34 and anti-vimentin antisera and negative with anti-FVIII and CD31 antisera. In two of five of the control cases without neurofibromatosis, the mammary stroma showed focal areas with features of PASH, but no multinucleated giant cells were present in any case. PASH with giant cells should be recognised as a feature of gynecomastia in von Recklinghausen's disease. The presence of multinucleated giant cells is very unusual and, although more cases have to be studied, these cells seem to be a feature of PASH occurring in patients with von Recklinghausen's disease.- - - - - - - - - - ranking = 5keywords = hyperplasia (Clic here for more details about this article) |
10/94. pyoderma vegetans and ulcerative colitis.pyoderma vegetans (PV) is a chronic, vegetating pustular disorder characterized clinically by erythematous vesiculopustular vegetating cutaneous plaques. Marked epidermal hyperplasia, intraepidermal and subepidermal neutrophilic microabscesses and a dermal inflammatory infiltrate are the prominent histopathological findings. We describe a patient with PV associated with ulcerative colitis and mammary Paget's disease. Pustular eruptions associated with ulcerative colitis are reviewed.- - - - - - - - - - ranking = 1keywords = hyperplasia (Clic here for more details about this article) |
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