Female Genital tract - B/88

Question 1

Inflammations of the breast

Answer 1

Infection, duct ectasia, traumatic fat necrosis

Question 2

Infection

Answer 2

relatively rare in the breast, usually linked to lactation

Question 3

Duct ectasia

Answer 3

Unknown etiology - ducts are dilated and filled with green-white matter which can be discharged from the nipple. Tissue around the duct contains lymphocytes, plasma cells and macrophages along with fibrosis.
Fibrosis can lead to retraction of the nipple, mimicking the effects of some carcinomas

Question 4

Traumatic fat necrosis

Answer 4

Fat necrosis due to trauma. Innocuous, but it produces a mass

Question 5

Fibirinocystic changes of the breast

Answer 5

Changes in the breast tissue which can range from harmless to changes associated with increased risk of carcinoma. May produce palpable “lumps”. Distinguished from cancer using fine-needle aspiration and biopsy along with histology.

The changes are a consequence of distortion or exaggeration of the cyclic changes which occur in the menstrual cycle. Can be non-proliferative or proliferative.

Question 6

Non-proliferative fibrinocystic changes

Answer 6

Increase in fibrous stroma, dilation of ducts - formation of cysts. They are bilateral, brown-blue and filled with serous fluid. May be calcification.
Either tall or flattened epithelium, called Apocrine metaplasia. Apocrine metaplasia is linked to a slight increased chance for carcinoma.

Question 7

Proliferative fibrinocystic changes

Answer 7

Epithelial hyperplasia - proliferation of epithelial cells with a wide spectrum of histological alterations: ductal papillomatosis (papillary processes which projects into the lumen of the dilated cysts), atypical lobular hyperplasia (cytologically resembles lobular carcinoma in situ, but with less distended cells - associated with 5x higher chance of carcinoma.

Sclerosing adeosis - enlargement of the lobule with many acini. Sclerosis is hardening. Proliferation of lining epithelial cells and myoepithelial cells in small ducts and ductules, which forms masses of small glad patterns within a fibrous stroma. The stroma in these cases may compress the lumina of the acini and make them seem like solid cords of cells.