Pathology

Question 1

Acute Mastitis:

• Caused by?
• Treatment?
• Can lead to what?
• Check that it isn’t what?

Answer 1

• Staph Aureus with breast feeding
• Continue feeding/ Dicloxacillin
• Abssess/ mass
• Inflammatory CA

Question 2

Periductal Mastitis:

• Bacterial?
• Inflammation of what? Can cause?
• Usually in who? Due to?
• What happens to the duct?
• Eventually leads to? (2)

Answer 2

• No
• Subaereloar ducts; nipple retraction
• Smokers; Low vitamin A
• Blocks with inflammation behind
• Fibrosis/ nipple retraction

Question 3

Mammary Duct Ectasia:

• Ectasia means?
• What happens in duct?
• Commonly in who?
• Discharge?
• Finding on histology?

Answer 3

• Dilation
• Inflammation/ dilation under areola
• Multperous/ post meno women
• Green/brown nipple discharge
• Chronic inflammation with plasma cells

Question 4

Fat Necrosis:

• Usually due to?
• On mammography?
• Histology?

Answer 4

• Trauma
• Mass with calcification
• Giant cell/ clacification

Question 5

Developmental:
1.) Accessory nipple where?
2.) Nipple retraction:
3.) Juvenile Hypertrophy is what?
Gynecomastia:
- In who? Uni/bi lateral? Due to? Occurs with? (4)

Answer 5

1. ) Along the milk line
2. ) Can happen
3. ) Huge Ta’s
   - Men; both; estrogen; drugs/Kline/Test. Tumor/Liver Dz

Question 6

Breast:

• 6 parts? Pathology of each?
• Guys don’t have what? pregnancy increases what?

Answer 6

1. ) Stroma: Fibroadenoma/phyllodes
2. ) Lobules: Lobular CA
3. ) Term. Ducts: Tubular CA
4. ) Major Duct: Fibrocystic change; DCIS; Invasive ductal CA
5. ) Lactiferous duct: Intraductal pailloma; Absess; mastitis
6. ) Nipple: Absess/ Paget
   - Lobules; Acini

Question 7

Fibrocystic Change:

• Often in who?
• Appearance?
• Increased risk of CA?
• Can find what on biopsy?

Answer 7

• Premenopausal women
• Lumpy breats; blue domed appearance
• None!
• Other changes

Question 8

Fibrocystic Change Other findings:

1. ) Fibrosis, cysts, apocrine metaplasia:
   - Any combo of the three risk of cancer?
2. ) Ductal hyperplasia:
   - Risk of invasive carcinoma?
3. ) Sclerosing Adenosis: Too many what in lobule?
   - What b/n glands? Risk of invasive carcinoma? Calcified?
4. ) Atypical Hyperplasia: Atypical where? (2)
   - Risk of invasive carcinoma? Applies to what?

Answer 8

1. ) None
2. ) 2x risk
3. ) Glands; fibrosis; 2x risk; Calcified
4. ) Atypical cells in duct or lobule; 5x risk; both breasts

Question 9

Intraductal Papilloma:

• Papillary growth into?
• Fibrovascular projection lined by?
• Bloody nipple?
• Must distinguish from?
• Common in who?
• No myoepi =?

Answer 9

• Large duct
• Epi and myoepi
• Yes
• Papillary carcinoma
• Premeno women
• More likely carcinoma

Question 10

Fibroadenoma:

• Benign tumor of? Risk of CA?
• Well circumscribed? Mobile? Marble like?
• Estrogen sensitive?
• Common in who?

Answer 10

• Fibrous tissue/gland; NONE
• Yes; yes; yes
• Yes
• Pre meno women

Question 11

Phyllodes Tumor:

• Fibroadenoma like tumor with increased what?
• Common in who?
• Malignant? Where? (2) What is malignant?

Answer 11

• Fibrous component
• Post meno women
• Can be malignant; lungs and bone; stromal component

Question 12

DCIS:

• Malignant prolif of cells where?
• Calcification?
• 2 types? 1 with bad prognosis?
• Pagets? Presents as what?

Answer 12

• In ducts
• YES!
• Comedo/cribrigorm; comedo
• DCIS up the duct; ulceration/erythema

Question 13

Invasive Ductal Carcinoma:

• Common?
• Dimpling?
• Biopsy shows what? (2)
  1. ) Tubular Carcinoma: Makes what? Stroma? Myoepi? Prognosis?
  2. ) Mucinous: Prognosis? Common in who? Assoc with?
  3. ) Inflammatory: Looks like what? Blocks what? Prog?
  4. ) Medullary: High grade? Lymphocytes? Assoc. with?

Answer 13

• More common than lobular
• Yes
• Duct like structures/ desmo stroma
  1. ) Tubules; desmoplastic; none; good
  2. ) good; elderly; BRCA 1
  3. ) Mastitis; lymphatics; bad
  4. ) Yes; many; BRCA1!!!!!!! Triple negative

Question 14

LCIS:

• Malignant prolif of?
• Mass/ calc?
• Cohesive cells?
• Multifocal/bilateral?
• Treatment? Removal?
• Increased risk to?

Answer 14

• Lobules
• No
• No E Cadherin
• often
• Tamoxifen; no
• Both breasts; unlike DCIS

Question 15

Invasive Lobular Carcinoma:

• Grows how?
• Duct formation?
• Lungs/ pleura? CSF/ GI/ Ovaries/ Uterus?

Answer 15

• Single file
• None; no E cadherin
• Less likely; more likely

Question 16

• Complete mole:
• Diandritic diploid? % persistant? % Chorio?
• Partial Mole: What on US?
• Placenta:
• What has high wt? (2) Low? How many veins?
• Fetal villious? Mother?
• GP stands for?
• 1st trimester issues? After that?
• Patau: Issues? (3)
• Edwards: Issues? (3)

Answer 16

• Yes; 20%; 1-2%
• Lacy Trophoblasts
• DM/Anemia; Pre-eclampsia; 2
• Intravillois; intervillous
• G = pregnant; TPAL (A

Question 17

• Routes of inflammatory to placenta? (2)
• Effect of Torches?
• Meconium mynecrosis: 12 hours? 6? 3? 1?
  1. ) Accreta?
  2. ) Increta?
  3. ) Pecreta?
  4. ) Previa?
  5. ) Abruptio?

Answer 17

• Ascending/ hematogenous
  Toxo = Choreoretinits/IC calc; Rubella = deaf/PDA/Blueberry muffin; CMV = deaf/rash; HSV2 = Temporal enceph; Syphillis = still birth/hyrdops
• Whatons jelly; Amnion ucler; chorion; amnion
  1.) No decidiua b/c attached to myometrium
  2.) Invades into myo
  3.) Penetrate through serosa
  4.) Covers Os
  5.) detach from placenta