Qap (Anatomical Pathology) 

QAP Peer Review

AP303
Case History: F/65 Left Breast mass
Intended diagnosis: Usual ductal hyperplasia. Contributed by:JKCC
Code Diagnosis Comment Score
anonymous Intraductal papilloma with atypical ductal hyperplasia nil  80
anonymous Intraductal papilloma with focal atypia perform immunostaining of neuroendocrine marker such as Syn,CgA,NSE to rule out neuroendocrine DCIS  80
anonymous Intraductal papilloma with atypical ductal hyperplasia; Fibrocystic change in adjacent area nil  80
anonymous Intraductal papilloma with atypical ductal hyperplasia; Fibrocystic change in adjacent area nil  80
anonymous Ductal papilloma with florid epithelial hyperplasia. The hyperplatic nature of the epithelial proliferation can be confirmed with immunostaining for estrogen receptor (ER) and high molecular weight cytokeratin (HMCK) (strong, diffuse HMCK and weak, heterogeneous ER in hyperplasia; strong uniform ER and weaker and non-uniform HMCK in low grade DCIS). Staining with myoepithelial markers (e.g. p63) will highlight the two cell types arrangment.  100
anonymous SOLID PAPILLARY CARCINOMA (Neuroendocrine ductal carcinoma in situ). Sampling to exclude invasion. DDX: Florid epitheliosis on intraduct papilloma. Look for monotonous ER staining and loss of HMWCK staining for DCIS.  50
anonymous Duct papilloma with florid epithelial hyperplasia (100%) & Columnar cell change/hyperplasia (100%) nil  100
anonymous Breast - Low grade DCIS in papillomas 90% - ADH in papillomas 10% Do immunostains CK14, ER. Diminished CK14 staining among proliferating ductal cells favor ADH/DCIS. More sampling to determine the size of lesion will determine if it is DCIS.  50
anonymous Intraductal papilloma with atypia, 100% nil  80
anonymous Benign epithelial proliferation nil  80
anonymous Intraductal Papilloma with usual ductal epithelial hyperplasia, with usual ductal hyperplasia in surrounding breast tissue. nil  100
anonymous INTRADUCTAL PAPILLOMA and USUAL DUCTAL HYPERPLASIA. nil  100
anonymous Intraductal papilloma wiht hyperplasia and fibrocystic change. (100%) nil  100
anonymous Intraduct papillary neoplasm with florid usual hyperplasia (epitheliosis) and focal atypia 100% Perform immunohistochemical study for neuroendocrine markers (Synaptophysin, Chromogranin) and examine more blocks to exclude micro/overt invasion.  80
anonymous Papilloma with adenomyoepitheliomatous focus/usual ductal hyperplasia (100%) Perform immunostaining for p63 to highlight the myoepithelial component.  100
anonymous Breast: intraductal papilloma and usual ductal hyperplasia (100% probability) nil  100
anonymous ? adenomyoepithelioma nil  80
anonymous Intraductal papilloma with atypical ductal hyperplasia (100%) nil  80
anonymous Intraductal papilloma 100% nil  100