3. 389. A 27-year-old female who is actively training for a
marathon presents with the new onset of a painful lump in
the upper outer quadrant of her right breast. A
mammogram shows an irregular mass with focal areas of
calcification. An excisional biopsy reveals a localized area
of granulation tissue and numerous lipid-laden
macrophages surrounding necrotic adipocytes.
What is the correct diagnosis?
a. Acute mastitis
b. Ectasia
c. Enzymatic fat necrosis
d. Foreign-body reaction
e. Traumatic fat necrosis
4. ACUTE MASTITIS
Mammogram
A. Mammogram shows diffuse increase in density and
trabecular thickening of left breast.
B. Ultrasonogram show irregular, hypoechoic fluid collections
that suggest abscess (arrows)
5. MORPHOLOGY :
Staph.localized area
of inflammation.
Strep. Inf. Diffuse,
spreading.
HPE : Involved breast
tissue –
necrotic, neutrophil
infiltration.
8. ENZYMATIC FAT NECROSIS
Enzymatic fat necrosis is due to the
action of lipases on triglycerides
resulting to saponification.
Traumatic fat necrosis occurs in the
female breast, mesenteries and in
the omentum. There is no
enzymatic lipolysis
10. FOREIGN BODY REACTION
Foreign body giant cell
inflammation that usually is
localized, and occurs 1-2 weeks
after trauma, surgery or radiation.
various kinds of foreign materials
which can be seen on
mammography below :-
11.
12. ANSWER E TRAUMATIC FAT NECROSIS
Mammography
The calcification of fat necrosis is
typically peripheral with a stippled
curvilinear appearance creating the
appearance of lucent "bubbles" in the
breast parenchyma.
Fat necrosis of the breast is
characterized by necrotic fat
surrounded by lipid-laden
macrophages and a
neutrophilic infiltration. It is
associated with trauma to
the breasts, usually in
women with pendulous
breasts.
13. photo of necrotic
nipple and areolae
Photo is approximately a
week after surgery. Most of
what you see is bruising.
However the black spots
are necrotic tissue.
14. 390. During a routine breast self-examination, a 35-
year-old female is concerned because her breasts feel
“lumpy.” She consults you as her primary care
physician. After performing an examination, you
reassure her that no masses are present and that the
“lumpiness” is due to fibrocystic changes.
Considering this clinical opinion, a pathologic finding
that is consistent with the nonproliferative form of
fibrocystic change is
a. A blue-domed cyst
b. A radial scar
c. Atypical hyperplasia
d. Papillomatosis
e. Sclerosing adenosis
15. ANSWER A BLUE DOMED CYST
BLUE – DOME CYSTS.
Nonproliferative changes include fibrosis of the stroma and
cystic dilation of the terminal ducts, which when large may
form blue-domed cysts.
16. RADIAL SCAR
.
radial scar of the
breast,is a benign
breast lesion that
can radiologically
mimic malignancy
The irregular scar
at the center of the
lesion,
representative of
the area of dense
fibrosis and
elastosis,
resembles a
carcinoma.
17. ATYPICAL HYPERPLASIA
Atypical hyperplasia is usually
discovered after a biopsy. The
tissue samples are examined
under a microscope, and the
pathologist identifies atypical
hyperplasia.
20. SCLEROSING ADENOSIS
Mammography
On mammography, sclerosing
adenosis may consist of architectural
distortion, indeterminate
microcalcifications.
most often in women in their 30s and
40s.
Only diagnosed during a routine
mammogram (breast x-ray)
21. 391. A 23-year-old woman presents with a rubbery, freely
movable 2-cm mass in the upper outer quadrant of the
left breast. A biopsy of this lesion would most likely
histologically reveal
a. Large numbers of neutrophils
b. Large numbers of plasma cells
c. Duct ectasia with inspissation of breast secretions
d. Necrotic fat surrounded by lipid-laden macrophages
e. A mixture of fibrous tissue and ducts
22. LARGE NUMBER OF NEUTROPHILS
ACUTE MASTITIS
Breast mass revealed the presence of a large number of
neutrophils, lymphocytes, and plasma cells in the stroma of
the left mammary gland.
23. LARGE NUMBER OF PLASMA CELLS
PLASMA CELLS MASTITIS
a variant of periductal mastitis
with prominent plasma cell
component
Infiltrate of plasma cells,
macrophages, lymphocytes
24. DUCT ECTASIA WITH INSPISSATION OF BREAST
SECRETIONS
Occurs in Pre or Post
menopausal state.
Mammary Duct
Ectacia
This was a breast
reduction specimen.
Microscopic examination
showed the inspissated
secretions to be duct
ectasia
29. 1. Of the following breast lesions, which is most
characteristically bilateral :
A.fat necrosis
B. fibroadenoma
C. intraductal papilloma of nipple ducts
D. lobular carcinoma-in-situ
E. Paget’s disease
LCIS is commonly multifocal and bilateral in its distribution.
2. The most important factor in breast enlargement during pregnancy
is
A. stromal edema
B. secretion of chorionic gonadotropin
C. glandular hyperplasia
D. proliferation of stroma
E. increased secretion of oxytocin
a normal hyperplastic response would be the growth and
multiplication of milk-secreting glandular cells in the breast as a
response to pregnancy, thus preparing for future breast feeding
30. 3.Which one of the following endometrial lesions is associated with the
highest risk of developing endometrial carcinoma?
A. Chronic endometritis
B. Complex hyperplasia with atypia
C. Complex hyperplasia without atypia
D. Simple hyperplasia
E. Squamous metaplasia
In general, any condition characterized by excessive estrogenic
stimulation is associated with some degree of endometrial hyperplasia
and increased risk of endometrial cancer.
4. All of the following are true regarding fibroadenoma EXCEPT:
A. It is the most common benign tumor of the female breast
B. More common in younger women
C. May enlarge late in the menstrual cycle and during pregnancy
D. Is an important risk factor for breast carcinoma
E. Usually presents as a solitary, moveable mass.
Fibroadenomas are completely benign and do not turn into (or
predispose the patient towards) carcinoma.
31. 5. Inflammation of the head of the penis is termed
A. Oophoritis
B. salpingitis
C. orchiditis
D. balanitis
E. Epididymitis
6. A male with testosterone deficiency may most likely be treated
with which of the following agents to restore and maintain normal
sexual function?
A. Carcinogenic
B. iatrogenic
C. estrogenic
D. androgenic
E. androgynous
Compounds that interact with androgen receptors in target tissues
to bring about the effects similar to those of testosterone.
