|
 Figure 4.1.1 ADH: A lobular unit is expanded by a proliferation of cells showing rigid architecture. |
 Figure 4.1.2 Several acini are partially populated by monotonous cells in ADH; note residual normally polarized cells at periphery of spaces and occasional irregularly shaped secondary spaces. |
 Figure 4.1.3 Uniform, evenly placed cells are present centrally in the involved spaces (right of center), while the cells at the periphery of the acini lack uniformity and maintain normal polarity, qualifying as ADH. |
 Figure 4.1.6 Low-grade DCIS. Three lobular units and ducts are populated by uniform cells with rigid architecture. |
 Figure 4.1.7 In addition to cytology and architecture, the extent of the proliferation, including involvement of true ducts, qualifies as DCIS. |
 Figure 4.1.8 Secretory material should not be misinterpreted as necrosis in this example of low-grade DCIS. |
 Figure 4.1.4 Despite cellular monotony, the peripheral secondary spaces are irregular in this example of ADH. |
 Figure 4.1.5 Uniform cells form microrosettes in this example of ADH. |
 Figure 4.1.9 The involved spaces are contiguous and completely replaced by the atypical cells, underscoring the importance of the extent of involvement in making the determination of DCIS. |
 Figure 4.1.10 Low-grade DCIS: Uniform cell population with distinct cell borders forms crisp secondary spaces. |
|
 Figure 4.2.1 ADH: A core needle biopsy specimen contains an expanded lobular unit; several of the spaces contain bulbous micropapillary projections. |
 Figure 4.2.2 Cellular uniformity of the micropapillary projections of ADH is evident even on low power. |
 Figure 4.2.3 Normally polarized cells are present between the micropapillae in this example of ADH. |
 Figure 4.2.6 Micropapillary DCIS (low grade): Several adjacent lobular units and intervening ducts contain a proliferation of micropapillae, with a “shaggy” appearance at low power. |
 Figure 4.2.7 This example of micropapillary DCIS also involves papillomas, explaining the presence of papillary projections with fibrovascular cores. |
 Figure 4.2.8 The micropapillae of DCIS are bulbous, with even cell placement; the architectural complexity of the proliferation is evidenced by the presence of seemingly unattached cell clusters within lumens. |
 Figure 4.2.4 Micropapillae of ADH lack fibrovascular cores. |
 Figure 4.2.5 ADH is composed of a uniform population of cells that are evenly distributed within the micropapillae, which extend to the basement membrane rather than being “perched” on the surface of the luminal epithelial layer. |
 Figure 4.2.9 Cells forming the micropapillae are similar to the adjacent cells lining the expanded spaces in this example of DCIS. |
 Figure 4.2.10 The micropapillae of DCIS are bulbous and are attached to the basement membrane. |
|
 Figure 4.3.1 Several adjacent lobular units are expanded by an epithelial proliferation that forms micropapillae, imparting a “shaggy” appearance to the spaces in DCIS. |
 Figure 4.3.2 Bulbous micropapillae of DCIS project from the basement membrane and some appear unattached within the lumen. |
 Figure 4.3.3 Some of the micropapillae are fused in this example of DCIS. |
 Figure 4.3.7 Hyperplasia resembling gynecomastia forms a nodule of fibrous stroma containing an epithelial proliferation. |
 Figure 4.3.8 Several lobular units and a true duct show an epithelial proliferation forming micropapillary structures in hyperplasia resembling gynecomastia. |
 Figure 4.3 9 Stromal changes accompany the epithelial hyperplasia; intralobular stroma is fibrous, similar to pseudoangiomatous stromal hyperplasia. |
 Figure 4.3.4 Micropapillary DCIS characteristically has a patchy distribution, with some spaces partially involved by micropapillae; however, the nonmicropapillary luminal epithelium has the same cytology as the micropapillae. |
 Figure 4.3.5 Detached micropapillae within the lumen highlight the 3-dimensional complexity of micropapillary DCIS. |
 Figure 4.3.6 Micropapillae of DCIS may appear tapered near the point of attachment; however, neoplastic cells are evenly distributed around the bulbous projections. Note similarity of the lining epithelium to that forming the micropapillae. |
 Figure 4.3.10 Micropapillae are focally present in true ducts as well as in lobular units in hyperplasia resembling gynecomastia. |
 Figure 4.3.11 Hyperplasia resembling gynectomastia is characterized by cells with pyknotic nuclei peripherally arranged around micropapillae with “empty” centers. |
 Figure 4.3.12 In hyperplasia resembling gynecomastia, micropapillae composed of cells with pyknotic nuclei appear “stuck” on the luminal epithelium, without connection to the basement membrane. The lining epithelium shows nuclear variability. |
|
 Figure 4.4.1 DCIS: Core needle biopsy specimen showing several lobular units and intervening ducts containing a solid epithelial proliferation with necrosis. |
 Figure 4.4.2 A papilloma is present (left of center), showing the same proliferation as the surrounding ducts in this example of DCIS. |
 Figure 4.4.3 Although there is a suggestion of nuclear streaming and swirling, cellular monotony is characteristic of DCIS. |
 Figure 4.4.5 A solid epithelial proliferation involves adjacent lobular units in florid hyperplasia without atypia. |
 Figure 4.4.6 Nuclear variability, cellular overlap, and irregular secondary spaces characterize florid hyperplasia without atypia. |
 Figure 4.4.7 Florid hyperplasia without atypia has irregular secondary spaces and indistinct cell borders. |
 Figure 4.4.4 Subtle microrosettes formed by uniform cells characterize this pattern of DCIS. The cells of adjacent microrosettes appear to overlap, but they are evenly distributed around their respective secondary spaces. |
 Figure 4.4.8 Nuclear variability and occasional inclusions “heliotropes” are a defining feature of florid hyperplasia without atypia. |
|
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
