Breast Pathology: Risk of Underdiagnosis in Breast Pathology: Case 4: Presented by Alena Skalova, MD Clinical History 53-year-old woman with no remarkable medical history
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Case 4: Presented by Alena Skalova, MD Clinical History 53-year-old woman with no remarkable medical history presented with painful left breast mass that had enlarged during the past year. Physical examination revealed a palpable, large, ill-defined lesion in the central area of left breast. No nipple discharge was noted. Surgical excision specimen consisted of 7x 5.5x 2.5 cm fibrofatty tissue with illdefined irregular pink-tan area that extended to the surgical margins and contained many microcystic spaces and dilated ducts filled with viscous, translucent mucoid material. Histologically, the lesion was characterized by multiple cystic structures that contained abundant eosinophilic, PAS-positive secretory material resembling thyroid colloid. The cysts were lined by flattened epithelium with focal micropapillary proliferations. Some epithelial cell revealed large polymorphic nuclei and distinctive large nucleoli, but the overall appearence was bland, and myoepithelial layer adjacent to proliferating epithelium was intact.
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