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Atypical Ductal Hyperplasia (Low Power)
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Atypical Ductal Hyperplasia (Low Power)

Low power view of several ducts cut longitudinally
Display multiple epithelial layers on top of an intact basement membrane
The spaces within the ducts vary from round to oval to slit like
The definitive diagnosis of atypical hyperplasia cannot be made without seeing the cytology of the cells, which should resemble carcinoma in situ
(Description By:Faripour Forouhar, M.D. )
(Image Contrib. by:Faripour Forouhar, M.D. UCHC )
Duct Hyperplasia with Atypia
Etiology

Secondary to an irregular response by breast tissue to hormonal stimuli
Pathogenesis

May be due to relative or absolute excess of estrogen, decrease in progesterone, or abnormal response to either hormone by breast tissue,
Epidemiology

Reproductive age women
General Gross Description

May be associated with microcalcifications within the lumens
Gross findings may be of fibrocystic change
General Microscopic Description

Ducts exhibit more than the usual two layer epithelium (inner cuboidal to columnar cells; outer layer of myoepithelium)
Either part or all of up to two ducts in one location (or a focus less than 2 mm in diameter) contain cells with all the cytologic and histologic features of duct carcinoma in situ
Features include loss of polarity to lumen, round "punched-out" lumens, and homogeneity of cells
Cells may show enlarged, round to oval nuclei and nucleoli
Clinical Correlation

Found either by mammography or incidentally
Increased risk of developing breast carcinoma 4-5x
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 1093-1097.
Duct Hyperplasia with Atypia
Synopsis by: Melinda Sanders M.D. (T04000M72175)[304]
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