Intraductal papillomas are benign breast lesions usually affecting the lactiferous ducts, but smaller peripheral ducts may also be involved.
They’re wart-like growths of gland tissue along with fibrous tissue and blood vessels (called fibrovascular tissue).
The larger lesions may present with intramural fragile masses but smaller ones may be evident only on microscopic examination.
Papillomas may be solitary or multiple.,The distinction is important as the multiple form is more frequently associated with atypical hyperplasia and DCIS, the latter usually of low grade type, which should be recorded separately. This malignant change may be focal within the lesion, and therefore extensive sampling may be required to detect it.
Solitary papillomas or solitary intraductal papillomas : are single tumors that usually occurs centrally in …show more content…
• Variable enhancement kinetics.
• Usually linear or clumped non masslike enhancement.
- Ductography: Intraluminal filling defect.
Microscopically, the papilloma consists of proliferation of ductal epithelium rested on fibrovascular stroma.
Epithelial component consist of cuboidal to columnar cells without pleomorphism, nuclear atypia or mitotic figures.
Myoepithalial layer is also preserved. Some papillomas have more complex structure accompanied by epithelial hyperplasia.
Absence of myoepithelial layer is a useful marker for recognition of the malignant transformation.
Epithelial hyperplasia without cytological atypia is often present and should not be recorded separately.
Atypical hyperplasia is rarely seen and, when present, should be recorded separately under ‘Epithelial proliferation’. Epithelial nuclei are usually vesicular with delicate nuclear membranes and inconspicuous nucleoli.
Apocrine metaplasia is frequently observed, but should not be recorded separately on the reporting form. Squamous metaplasia is sometimes seen, particularly near areas of