Home   Chapter Home   Jobs   Conferences   Fellowships   Books

 

 

Advertisement 

 

Breast-nonmalignant

Benign tumors / change

Sclerosing lobular hyperplasia

 

Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)

Revised: 9 October 2012, last major update April 2010

Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.

 

Definition

=========================================================================

● Uncommon benign lesion of young women, with enlarged breast lobules due to ductal and acinar proliferation but normal architecture

 

Terminology

=========================================================================

 

Epidemiology

=========================================================================

● Young women, often African-American

 

Sites

=========================================================================

 

Etiology

=========================================================================

 

Clinical features

=========================================================================

● Uncommon (3-7% of benign breast lesions) benign proliferative lesion of breast

● Causes local pain

Radiology: no associated microcalcifications

 

Prognostic factors

=========================================================================

 

Case reports

=========================================================================

12 year old girl with fine needle aspiration cytology (Cytojournal 2006;3:8)

● 20 year old woman with well circumscribed breast mass (Arch Pathol Lab Med 2005;129:1345)

● 22 year old woman (Case of the Week #62)

 

Treatment

=========================================================================

● Excision; does not recur

 

Clinical images

=========================================================================

 

Gross description (Macroscopy)

=========================================================================

● Well circumscribed mass, tan-white, firm, homogeneous cut surface, few scattered slit-like spaces

● No hemorrhage or necrosis

 

Gross images

=========================================================================

 

  

White, firm and homogeneous

 

Micro description (Histopathology)

=========================================================================

● Well circumscribed but not encapsulated

● Enlarged breast lobules with ductal and acinar proliferation but normal architecture

● Focal lobular hyperplasia

● Prominent fibroblastic and myofibroblastic proliferation with dense keloid-like intralobular fibrosis and slit-like areas resembling pseudoangiomatous stromal hyperplasia

● May coexist with or be overgrown by fibroadenoma (Hum Pathol 1984;15:336)

No/rare mitotic figures, no atypia

 

Micro images

=========================================================================

 

  

Well circumscribed lesion

 

 

      

Multiple large lobules with increased ductules and acini

Stroma is dense collagenous fibrosis, relatively bland and acellular

 

 

         

Dense keloid-like collagenous fibrosis

Prominent fibroblastic and myofibroblastic proliferation forming slit-like spaces

resembling pseudoangiomatous stromal hyperplasia

Dense intralobular stroma with dilated ducts

 

 

                             

Dense interlobular fibrosis has                      CK8+ lobules          Myoepithelial cells are calponin+

glomeruloid pattern with trichrome stain

 

 

Fig 1: normal lobular architecture

Fig 2: marked sclerosis of stroma, more prominent at periphery

Fig 3: microscopic focus of fibroadenoma

 

Virtual Slides

=========================================================================

 

Videos

=========================================================================

 

Cytology description

=========================================================================

● Uniform, round/oval ductal epithelial cells in sheets, acini, small and large clusters; no atypia

● Occasional stromal fragments and bare nuclei

● No branched tubular fragments

● Resembles fibroadenoma

● Cytology by itself is not diagnostic

 

Cytology images

=========================================================================

 

                                                                               

Moderately cellular with mammary ductal                  Occasional scattered stromal fragments

epithelial and myoepithelial cells in clusters

and as tubular fragments

 

 

               

Ductal cells have round/oval nuclei with

dispersed chromatin and moderate

basophilic cytoplasm

 

Positive stains

=========================================================================

Epithelium:

● CK8

 

Fibrosis:

● Trichrome

 

Negative stains

=========================================================================

 

Electron microscopy descriptions

=========================================================================

 

Electron microscopy images

=========================================================================

 

Molecular / cytogenetics description

=========================================================================

 

Molecular / cytogenetics images

=========================================================================

 

 

Differential Diagnosis

=========================================================================

Fibroadenoma: treated similarly, but has irregular proliferating ducts and loose cellular stroma

 

Additional references

=========================================================================

 

End of Breast-nonmalignant > Benign tumors / change > Sclerosing lobular hyperplasia

 

 

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must also be interpreted in the context of a patient's clinical data using reasonable medical judgment.  This website should not be used as a substitute for the advice of a licensed physician.

 

All information on this website is protected by copyright of PathologyOutlines.com, Inc.  Information from third parties may also be protected by copyright.  Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).