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15 May 2013 - Case of the Week #273

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Thanks to Dr. Lamiaa Rouas, Mohamed V University School of Medicine (Morocco), for contributing this case and the discussion. To contribute a Case of the Week, follow the guidelines on our Case of the Week page.

July 15-19, 2013
Snow King Resort
Jackson, Wyoming

30th Annual Summer Update
In Clinical Immunology, Microbiology, and Infectious Diseases

This 24.25 hour review and update in the areas of clinical immunology, microbiology, and infectious diseases is intended to improve knowledge about the pathogenesis and clinical manifestations of infectious diseases, immunological mechanisms of disease and disease prevention, appropriate approaches to the diagnosis of infections and immunologic disorders, and utilization of the clinical microbiology and immunology laboratory including selection and interpretation of results.

This course will provide a forum for the exchange of ideas dealing with microbial infections as well as immunity to infectious diseases and immunologic disorders. Faculty consists of clinicians involved in patient care, pathologists, and clinical laboratory scientists. Discussion of timely topics by faculty and participants assures that this course will be informative, interesting, and relevant.

Course Directors:
Harry R. Hill, MD
Larry G. Reimer, MD
Judy A. Daly, PhD

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Case of the Week #273

Clinical History:

A 42 year old pregnant woman (first pregnancy) presented at 30 weeks gestation with an ulcerated nodule on the right labia minor. The lesion had been present for more than a year, but was exaggerated during pregnancy.

Physical examination showed a 2 cm mobile polyp with an ulcerated surface on the right labia minor, but was otherwise normal. There were no palpable breast masses, axillary or cervical lymphadenopathy. The polyp was biopsied.

Clinical images:

Click here to view image.

Micro images:





What is your diagnosis?































Diagnosis:

Ectopic mammary tissue of the vulva

Discussion:

The biopsy revealed an ulcerated polyp. Within its core are mammary-like ducts with a fibroadenomatous appearance. The tubules are lined by low columnar epithelium with uniform nuclei surrounded by a myoepithelial layer. The stroma is myxoid, with loose connective tissue and scattered inflammatory cells. The polyp surface had granulation tissue and acute inflammatory cells. There was no evidence of malignancy. Immunohistochemical testing was not done.

Ectopic mammary tissue occurs along the primitive milk line, from the axilla to groin (Vulva-ectopic mammary tissue at PathologyOutlines.com). It is considered by some to be a normal constituent of the anogenital area, which undergoes the same pathologic processes as in the breast (Adv Anat Pathol 2011;18:1). Excision is recommended to prevent development of these benign or malignant processes (Obstet Gynecol 2011;118:478)

Nat Pernick, M.D., President
and Palak Thakore, Associate Medical Editor
PathologyOutlines.com, Inc.
30100 Telegraph Road, Suite 408
Bingham Farms, Michigan (USA) 48025
Telephone: 248/646-0325
Email: NatPernick@Hotmail.com
Alternate email: NatPernick@gmail.com