Based on actual cases drawn from the extensive breast pathology consultation practice at Vanderbilt University Medical Center, Breast Pathology covers the full classification of breast tumors and focuses on especially challenging differential diagnoses or unusual and problematic morphologic presentations. Using a pattern-based approach, each case is presented as a difficult diagnostic choice with two or even three possible diagnoses for the pathologist. For each case there is a description illustrating an expert’s diagnosis and analysis, along with commentary providing additional context on the evaluation of such specimens. The book places special emphasis on avoiding diagnostic pitfalls. Each case discussion is supported with several high quality color photomicrographs that facilitate an extensive visual history and learning experience. Brief references to the literature are also included.
The book presents a foreword by David L. Page, MD, Professor of Pathology, Vanderbilt University Medical Center.
Key Features of Breast Pathology :
- Provides a pattern-based approach to solving difficult diagnostic challenges
- Offers expert guidance to complex diagnoses of breast specimens
- Emphasizes difficult diagnoses and how to avoid diagnostic pitfalls
- Based on actual cases drawn from breast pathology consultation practice at Vanderbilt University Medical Center
- Includes over 400 high quality color photomicrographs
สารบัญ
1.Alterations of enlarged lobular units1.1apocrine cyst versus columnar cell lesion without atypia1.2columnar cell lesion with atypia versus columnar cell lesion without atypia1.3secretory change versus columnar cell lesion with atypia 1.4hypersecretory change versus ductal carcinoma in situ 1.5papillary apocrine change versus apocrine ductal carcinoma in situ2. Epithelial proliferative lesions 2.1Usual hyperplasia versus atypical ductal hyperplasia2.2Gynecomastoid ñtype hyperplasia versus micropapillary atypical ductal hyperplasia or micropapillary ductal carcinoma in situ2.3 Usual hyperplasia (solid pattern) versus atypical ductal hyperplasia2.1Prominent myoepithelial cells versus atypical ductal hyperplasia2.2Papilloma involved by florid hyperplasia versus atypical ductal hyperplasia 2.3Atypical ductal hyperplasia versus low grade ductal carcinoma in situ2.4Cribriform atypical ductal hyperplasia versus collagenous spherulosis2.5Atypical ductal hyperplasia versus atypical lobular hyperplasia2.6Florid hyperplasia versus intermediate or high grade ductal carcinoma in situ2.7Mucocele-like lesion with atypical ductal hyperplasia versus mucocele-like lesion without atypia2.8Papillary apocrine change versus apocrine atypical ductal hyperplasia or apocrine ductal carcinoma in situ 3 Ductal carcinoma in situ3.1Ductal carcinoma in situ versus atypical lobular hyperplasia in a papilloma3.2Ductal carcinoma in situ versus microinvasive carcinoma3.3Entrapped epithelial elements post biopsy of ductal carcinoma in situ in papilloma versus invasion3.4Spindle cell pattern ductal carcinoma in situ versus florid hyperplasia3.5Encysted noninvasive papillary carcinoma versus atypical ductal hyperplasia in a papilloma3.6Pagetís disease versus toker cells3.7Ductal carcinoma in situ versus lobular carcinoma in situ3.8Secretory ductal carcinoma in situ versus usual hyperplasia with clear cells3.9Pagetoid pattern ductal carcinoma in situ versus ALH3.10Radiation change versus ductal carcinoma in situ4Lobular carcinoma in situ4.1Classic lobular carcinoma in situ versus variant lobular carcinoma in situ4.2Classic lobular carcinoma in situ versus atypical lobular hyperplasia4.3Usual hyperplasia with prominent myoepithelial cells versus lobular neoplasia4.4Ductal involvement by cells of atypical lobular hyperplasia versus low grade ductal carcinoma in situ5Sclerosing and adenotic lesions5.1Nodular sclerosing adenosis versus papilloma5.2Papilloma versus adenomyoepithelioma5.3Radial scar versus pure tubular carcinoma5.4Sclerosed adenotic papilloma versus tubular carcinoma5.5Sclerosing adenosis versus microglandular adenosis5.6Nonspecific perilobular or periductal chronic inflammation versus sclerosing lymphocytic lobulitis6Fibroepithelial lesions6.1Fibroadenoma versus cellular fibroadenoma6.2Fibroadenoma versus benign phyllodes tumor6.3Benign phyllodes tumor versus borderline phyllodes tumor6.4Borderline phyllodes tumor versus malignant phyllodes tumor6.5Malignant phyllodes tumor versus pure sarcoma 7Stromal lesions7.1Myofibroblastoma versus fibromatosis7.2Epithelioid myofibroblastoma versus pure invasive lobular carcinoma7.3Myofibroblastoma versus low grade spindle cell metaplastic carcinoma7.4Spindle cell metaplastic carcinoma versus post biopsy spindle cell nodule7.5Fibromatosis versus scar8Special type carcinomas8.1Invasive pure lobular carcinoma versus lobular variant carcinomas versus no special type carcinoma with lobular features 8.2Pure nvasive cribriform carcinoma versus cribriform ductal carcinoma in situ 8.3Invasive pure tubular carcinoma versus no special type carcinoma with tubular features 8.4Pure mucinous carcinoma versus mucocele-like lesion8.5Pure medullary carcinoma versus no special type carcinoma with medullary features8.6Secretory carcinoma versus no special type carcinoma8.7Adenoid cystic carcinoma versus no special type carcinoma with myoepithelial phenotype or ductal carcinoma in situ 8.8Low grade spindle cell metaplastic carcinoma versus fibromatosis8.9Adenosquamous carcinoma versus squamous metaplasia8.10Histiocytes versus histiocytoid variant of invasive lobular carcinoma8.11Atypical lobular hyperplasia involving sclerosing adenosis versus invasive lobular carcinoma9Invasive carcinomas of no special type, special considerations9.1Lymphovascular invasion versus retraction artifact9.2Invasive micropapillary features versus retraction artifact9.3No special type tumors with immunohistochemical evidence of neuroendocrine differentiation versus small cell carcinoma9.4High grade carcinoma versus lymphoma10Sentinel lymph nodes 10.1Benign transport versus isolated tumor cell clusters10.2Isolated tumor cells versus micrometastasis10.3Micrometastasis versus capsular lymphatic involvement10.4Micrometastasis versus benign glandular inclusion11Vascular lesions of the breast11.1Perilobular capillary hemangioma11.2Atypical vascular lesion 11.3Low grade angiosarcoma 11.4High grade angiosarcoma11.5Epithelioid angiosarcoma
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Jean F. Simpson, MD, is President, Breast Pathology Consultants, Inc., Nashville, TN; and Adjunct Professor of Pathology, University of South Alabama, Mobile, Alabama
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