Anatomia Patologica
P.O. De Gironcoli
Conegliano
Resp. dott.ssa Lucia Bittesini
Piernicola Machin
L.D., 50 anni,microcalcificazioni QIE dx
EE
EE10x
10x
EE 10x
EE 20x
EE 40x
EE 20x
EE 40x
B2
B3
B5
B2
B3
B5
DIAGNOSI.
Parenchima mammario con focolai di iperplasia dutto-lobulare
a fisionomia apocrina con lieve atipia e necrosi intraduttale,
associata a calcificazioni grossolane. Focale, puntiforme e irregolare
positività per proteina p63, proteina 100 e actina 1A4.
DIN1b/DIN1c
(IDA/DCIS BG)
QUADRANTECTOMIA
+
LINFONODO SENTINELLA
+
SVUOTAMENTO LINFONODALE
EE 5x
EE 10x
EE 40x
EE 40x
DIAGNOSI su QUAD
Condizione post-mammotome con reazione cicatriziale
in fase di consolidamento...associata alla presenza di focolaio di
neoplasia duttale intraepiteliale ben differenziata.
La neoplasia si associa a numerosi cluster di calcificazioni
di tipo displasico.
pTisN0(sn), G1
DIN1c
(DCIS BG)
Follow-up
Radiologo
Patologo
Oncologo
Chirurgo
GRAZIE
B2
B3
Although follow-up excision cannot be strongly recommended in ALH and FEA, it should be considered since the upgrade risk is not negligible
ADH lesions with significant cytologic atypia and/or necrosis are most likely to be
associated with carcinoma and should be excised. ADH without these features, regardless
of extent of involvement, and with [95% removal of the targeted calcifications, is
associated with a minimal risk (\3%) of carcinoma and may undergo mammographic
follow-up only.
Ann Surg Oncol. 2010 Oct 23.
1845 biopsie in 3 anni
122 biopsie(B3)
91 sintomatiche
FEA 18%
ADH
31 screening
ESCISSIONE
90%B
9
10%M
Current management of FEA is best achieved through a multidisciplinary review
considering various factors to determine if surgical excision is warranted. Further
studies are required to elucidate the malignant potential of this columnar cell lesion.
The American Journal of Surgery