Breast Pathology: Diagnostic Insights and Image Analysis Quiz

1. What type of lesion is shown in the image?

Phyllodes Tumor of Breast

Fibroadenoma of Breast

Breast Carcinoma

The image shows an intraductal papilloma arising in a small duct. Such lesions are microscopic and not detected on palpation. The average age at presentation is 48 yrs. Fibroadenomas are benign breast tumors commonly detected by palpation. Breast Carcinoma refers to malignant breast cancer. Phyllodes Tumors of the breast are rare fibroepithelial tumors that can be benign or malignant.

Explanation

The image shows an intraductal papilloma arising in a small duct. Such lesions are microscopic and not detected on palpation. The average age at presentation is 48 yrs. Fibroadenomas are benign breast tumors commonly detected by palpation. Breast Carcinoma refers to malignant breast cancer. Phyllodes Tumors of the breast are rare fibroepithelial tumors that can be benign or malignant.

2. What architectural feature is characteristic of Intraductal Papilloma of Breast?

Irregular shape

Smooth surface

Central necrosis

Intraductal papillomas of the breast exhibit complex, intricate branching fronds that are lined by cuboidal or columnar cells and myoepithelial cells.

Explanation

Intraductal papillomas of the breast exhibit complex, intricate branching fronds that are lined by cuboidal or columnar cells and myoepithelial cells.

3. Which of the following is a likely diagnosis for a 1.5 cm intraductal papilloma that created a palpable subareolar mass accompanied by bloody nipple discharge?

Fibrocystic Changes in Breast

Invasive Ductal Carcinoma

Fibroadenoma of Breast

Intraductal papilloma of the breast typically presents as a solitary lesion that can cause bloody nipple discharge and a palpable mass. Fibroadenomas are benign solid breast masses, invasive ductal carcinoma is a malignant breast cancer, and fibrocystic changes refer to benign breast changes characterized by cysts and fibrous tissue.

Explanation

Intraductal papilloma of the breast typically presents as a solitary lesion that can cause bloody nipple discharge and a palpable mass. Fibroadenomas are benign solid breast masses, invasive ductal carcinoma is a malignant breast cancer, and fibrocystic changes refer to benign breast changes characterized by cysts and fibrous tissue.

4. What is a benign hyperplastic process of the breast that may be mistaken for carcinoma?

Invasive Ductal Carcinoma

Lobular Carcinoma In Situ

Ductal Carcinoma In Situ

Sclerosing adenosis is a benign hyperplastic process that may be mistaken for carcinoma, but it retains its lobular configuration and is more cellular centrally.

Explanation

Sclerosing adenosis is a benign hyperplastic process that may be mistaken for carcinoma, but it retains its lobular configuration and is more cellular centrally.

5. What is a typical histological characteristic of Sclerosing Adenosis of Breast?

Complete absence of myoepithelial cells in the tubules

High mitotic activity and nuclear pleomorphism throughout the lesion

Presence of cystic spaces within the proliferating tubules

Sclerosing Adenosis of Breast is characterized by elongated tubules with attenuated lumens, preservation of myoepithelial cells, and less conspicuous epithelial cells. Cystic spaces, absence of myoepithelial cells, and high mitotic activity with nuclear pleomorphism are not typical features of this condition.

Explanation

Sclerosing Adenosis of Breast is characterized by elongated tubules with attenuated lumens, preservation of myoepithelial cells, and less conspicuous epithelial cells. Cystic spaces, absence of myoepithelial cells, and high mitotic activity with nuclear pleomorphism are not typical features of this condition.

6. What type of cells may predominate in some cases of sclerosing adenosis of breast?

Fibroblasts

Adipocytes

Lymphocytes

Sclerosing adenosis of the breast may show a predominance of myoepithelial component, which can be confirmed with immunohistochemical stains.

Explanation

Sclerosing adenosis of the breast may show a predominance of myoepithelial component, which can be confirmed with immunohistochemical stains.

7. What is a characteristic feature of some cases of sclerosing adenosis of the breast that may lead to a mistaken diagnosis of well-differentiated ductal carcinoma?

Central necrosis

Multifocal distribution

Stromal invasion

Some cases of sclerosing adenosis don't have lobulocentric architecture and may have infiltrative edges, which may lead to the mistaken diagnosis of well-differentiated ductal carcinoma.

Explanation

Some cases of sclerosing adenosis don't have lobulocentric architecture and may have infiltrative edges, which may lead to the mistaken diagnosis of well-differentiated ductal carcinoma.

8. Which of the following best describes the histological features of fibroadenoma?

Lobular carcinoma in situ: Invasive lobular carcinoma

Fibrocystic changes: Adenosis

Invasive ductal carcinoma: Ductal carcinoma in situ

The tubules and glands in a fibroadenoma are lined by cuboidal or low columnar epithelium with uniform nuclei and surrounded by a myoepithelial layer. The stroma is made up of loose connective tissue.

Explanation

The tubules and glands in a fibroadenoma are lined by cuboidal or low columnar epithelium with uniform nuclei and surrounded by a myoepithelial layer. The stroma is made up of loose connective tissue.