Intracystic papillary carcinoma of the breast - Revision history

Michael: touch

2015-04-29T05:18:15Z

touch

← Older revision		Revision as of 05:18, 29 April 2015
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	{{ Infobox diagnosis		{{ Infobox diagnosis
	\| Name = {{PAGENAME}}		\| Name = {{PAGENAME}}
	\| Image = Breast PapillaryCarcinomaEncysted PA.JPG		\| Image = Breast PapillaryCarcinomaEncysted PA.JPG
	\| Width =		\| Width =
	\| Caption = Intracystic Papillary Breast Carcinoma. [[H&E stain]].		\| Caption = Intracystic Papillary Breast Carcinoma. [[H&E stain]].

Michael: /* Microscopic */ wikify

2015-04-28T16:06:10Z

Microscopic: wikify

← Older revision		Revision as of 16:06, 28 April 2015
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	***ER staining will be heterologous in a benign lesion.		***ER staining will be heterologous in a benign lesion.
	***Myoepithelial markers (calponin/p63/SMA +ve)s hould be positive in a benign lesion.		***Myoepithelial markers (calponin/p63/SMA +ve)s hould be positive in a benign lesion.
	*[[Papillary ductal carcinoma in situ]]		*[[Papillary ductal carcinoma in situ]].
	**Papillary DCIS shows myoepithelial cells (calponin/p63/SMA +ve) at the periphery of the involved spaces		**Papillary DCIS shows myoepithelial cells (calponin/p63/SMA +ve) at the periphery of the involved spaces
	**But papillary DCIS should be negative for myoepithelial cells within the focus of DCIS		**But papillary DCIS should be negative for myoepithelial cells within the focus of DCIS
	**Papillary intracystic carcinoma does not show myoepithelial cells at the periphery of the involved spaces		**Papillary intracystic carcinoma does not show myoepithelial cells at the periphery of the involved spaces
	*Invasive papillary carcinoma of the breast		*[[Invasive papillary carcinoma of the breast]].
	**Similar architecture but no cystic space, frankly invasive.		**Similar architecture but no cystic space, frankly invasive.
	**Very rare.		**Very rare.

Michael: tweak formating

2015-04-28T15:49:50Z

tweak formating

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	\| Syndromes =		\| Syndromes =
	\| Clinicalhx =		\| Clinicalhx =
	\| Signs =		\| Signs = +/-bloody discharge from nipple
	\| Symptoms =		\| Symptoms =
	\| Prevalence = Rare		\| Prevalence = Rare
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	\| Prognosis = very good		\| Prognosis = very good
	\| Other =		\| Other =
	\| ClinDDx = other breast ~~tumour~~		\| ClinDDx = other breast tumours
	\| Tx = surgical		\| Tx = surgical
	}}		}}
	'''Intracystic papillary carcinoma of the breast''', also known as '''encapsulated papillary carcinoma of the breast''' (abbreviated '''EPC'''), is an uncommon type of [[breast cancer]] with a very good prognosis.		'''Intracystic papillary carcinoma of the breast''', also known as '''encapsulated papillary carcinoma of the breast''' (abbreviated '''EPC'''), is an uncommon type of [[breast cancer]] with a very good prognosis.

			It should not be confused with the ''[[invasive papillary carcinoma of the breast]]'', a more aggressive tumour of the breast.

	==General==		==General==
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	**Scattered large cells with pale eosinophilic cytoplasm may be observed<ref>{{Cite journal \| last1 = Collins \| first1 = LC. \| last2 = Schnitt \| first2 = SJ. \| title = Papillary lesions of the breast: selected diagnostic and management issues. \| journal = Histopathology \| volume = 52 \| issue = 1 \| pages = 20-9 \| month = Jan \| year = 2008 \| doi = 10.1111/j.1365-2559.2007.02898.x \| PMID = 18171414 }}		**Scattered large cells with pale eosinophilic cytoplasm may be observed<ref>{{Cite journal \| last1 = Collins \| first1 = LC. \| last2 = Schnitt \| first2 = SJ. \| title = Papillary lesions of the breast: selected diagnostic and management issues. \| journal = Histopathology \| volume = 52 \| issue = 1 \| pages = 20-9 \| month = Jan \| year = 2008 \| doi = 10.1111/j.1365-2559.2007.02898.x \| PMID = 18171414 }}
	</ref>.		</ref>.
	***These cells are so-called globoid cells or clear cells and are immunoreactive for GCDFP-15.		***These cells are so-called globoid cells or clear cells and are immunoreactive for [[GCDFP-15]].
	***They should not be mistaken for myoepithelial cells.		***They should not be mistaken for myoepithelial cells.
	**Neoplastic epithelial cells:		**Neoplastic epithelial cells:
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	Notes:		Notes:
	*Many potential pitfalls with papillary breast lesions on needle core biopsy.		*Many potential pitfalls with papillary breast lesions on needle core biopsy.
	**Complete excision is recommended<ref>{{Cite journal \| last1 = Rizzo \| first1 = M. \| last2 = Linebarger \| first2 = J. \| last3 = Lowe \| first3 = MC. \| last4 = Pan \| first4 = L. \| last5 = Gabram \| first5 = SG. \| last6 = Vasquez \| first6 = L. \| last7 = Cohen \| first7 = MA. \| last8 = Mosunjac \| first8 = M. \| title = Management of papillary breast lesions diagnosed on core-needle biopsy: clinical pathologic and radiologic analysis of 276 cases with surgical follow-up. \| journal = J Am Coll Surg \| volume = 214 \| issue = 3 \| pages = 280-7 \| month = Mar \| year = 2012 \| doi = 10.1016/j.jamcollsurg.2011.12.005 \| PMID = 22244207 }}</ref>.		**Complete excision is recommended.<ref name=pmid22244207>{{Cite journal \| last1 = Rizzo \| first1 = M. \| last2 = Linebarger \| first2 = J. \| last3 = Lowe \| first3 = MC. \| last4 = Pan \| first4 = L. \| last5 = Gabram \| first5 = SG. \| last6 = Vasquez \| first6 = L. \| last7 = Cohen \| first7 = MA. \| last8 = Mosunjac \| first8 = M. \| title = Management of papillary breast lesions diagnosed on core-needle biopsy: clinical pathologic and radiologic analysis of 276 cases with surgical follow-up. \| journal = J Am Coll Surg \| volume = 214 \| issue = 3 \| pages = 280-7 \| month = Mar \| year = 2012 \| doi = 10.1016/j.jamcollsurg.2011.12.005 \| PMID = 22244207 }}</ref>
	*Adequately and carefully sample the specimen to exclude an invasive component.		*Adequately and carefully sample the specimen to exclude an invasive component.
	*Report only the size of the invasive component (if present) to prevent over-estimation of tumor stage.		*Report only the size of the invasive component (if present) to prevent over-estimation of tumor stage.

	DDx<ref>{{Cite journal \| last1 = Collins \| first1 = LC. \| last2 = Schnitt \| first2 = SJ. \| title = Papillary lesions of the breast: selected diagnostic and management issues. \| journal = Histopathology \| volume = 52 \| issue = 1 \| pages = 20-9 \| month = Jan \| year = 2008 \| doi = 10.1111/j.1365-2559.2007.02898.x \| PMID = 18171414 }}		DDx:<ref name=pmid18171414>{{Cite journal \| last1 = Collins \| first1 = LC. \| last2 = Schnitt \| first2 = SJ. \| title = Papillary lesions of the breast: selected diagnostic and management issues. \| journal = Histopathology \| volume = 52 \| issue = 1 \| pages = 20-9 \| month = Jan \| year = 2008 \| doi = 10.1111/j.1365-2559.2007.02898.x \| PMID = 18171414 }}
	</ref><ref>{{Cite journal \| last1 = Pathmanathan \| first1 = N. \| last2 = Albertini \| first2 = AF. \| last3 = Provan \| first3 = PJ. \| last4 = Milliken \| first4 = JS. \| last5 = Salisbury \| first5 = EL. \| last6 = Bilous \| first6 = AM. \| last7 = Byth \| first7 = K. \| last8 = Balleine \| first8 = RL. \| title = Diagnostic evaluation of papillary lesions of the breast on core biopsy. \| journal = Mod Pathol \| volume = 23 \| issue = 7 \| pages = 1021-8 \| month = Jul \| year = 2010 \| doi = 10.1038/modpathol.2010.81 \| PMID = 20473278 }}</ref>:		</ref><ref>{{Cite journal \| last1 = Pathmanathan \| first1 = N. \| last2 = Albertini \| first2 = AF. \| last3 = Provan \| first3 = PJ. \| last4 = Milliken \| first4 = JS. \| last5 = Salisbury \| first5 = EL. \| last6 = Bilous \| first6 = AM. \| last7 = Byth \| first7 = K. \| last8 = Balleine \| first8 = RL. \| title = Diagnostic evaluation of papillary lesions of the breast on core biopsy. \| journal = Mod Pathol \| volume = 23 \| issue = 7 \| pages = 1021-8 \| month = Jul \| year = 2010 \| doi = 10.1038/modpathol.2010.81 \| PMID = 20473278 }}</ref>:
	*[[Intraductal papilloma]].		*[[Intraductal papilloma]].

Michael: /* References */

2015-04-28T15:42:13Z

References

← Older revision		Revision as of 15:42, 28 April 2015
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	[[Category:Diagnosis]]		[[Category:Diagnosis]]
	[[Category:~~Invasive breast cancer~~]]		[[Category:Breast pathology]]

Michael: move from "Intracystic papillary breast carcinoma"

2015-04-28T15:40:15Z

move from "Intracystic papillary breast carcinoma"

← Older revision		Revision as of 15:40, 28 April 2015
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	~~#redirect~~ [[~~Invasive_breast_cancer#Invasive_papillary_carcinoma_of_the_breast~~]]		{{ Infobox diagnosis
			\| Name = {{PAGENAME}}
			\| Image = Breast PapillaryCarcinomaEncysted PA.JPG
			\| Width =
			\| Caption = Intracystic Papillary Breast Carcinoma. [[H&E stain]].
			\| Synonyms =
			\| Micro = Papillary lesion within a cyst
			\| Subtypes =
			\| LMDDx = [[Intraductal papilloma]], papillary [[DCIS]], [[Invasive papillary breast carcinoma]]
			\| Stains =
			\| IHC =
			\| EM =
			\| Molecular =
			\| IF =
			\| Gross =
			\| Grossing =
			\| Site = [[breast]]
			\| Assdx =
			\| Syndromes =
			\| Clinicalhx =
			\| Signs =
			\| Symptoms =
			\| Prevalence = Rare
			\| Bloodwork =
			\| Rads =
			\| Endoscopy =
			\| Prognosis = very good
			\| Other =
			\| ClinDDx = other breast tumour
			\| Tx = surgical
			}}
			'''Intracystic papillary carcinoma of the breast''', also known as '''encapsulated papillary carcinoma of the breast''' (abbreviated '''EPC'''), is an uncommon type of [[breast cancer]] with a very good prognosis.

			==General==
			*Very good prognosis<ref name=pmid21753694>{{Cite journal \| last1 = Rakha \| first1 = EA. \| last2 = Gandhi \| first2 = N. \| last3 = Climent \| first3 = F. \| last4 = van Deurzen \| first4 = CH. \| last5 = Haider \| first5 = SA. \| last6 = Dunk \| first6 = L. \| last7 = Lee \| first7 = AH. \| last8 = Macmillan \| first8 = D. \| last9 = Ellis \| first9 = IO. \| title = Encapsulated papillary carcinoma of the breast: an invasive tumor with excellent prognosis. \| journal = Am J Surg Pathol \| volume = 35 \| issue = 8 \| pages = 1093-103 \| month = Aug \| year = 2011 \| doi = 10.1097/PAS.0b013e31821b3f65 \| PMID = 21753694 }}</ref> - it is similar to [[DCIS]].
			*Classically menopausal women.
			*~30% present with bloody discharge.<ref name=pmid21057133>{{Cite journal \| last1 = Rodríguez \| first1 = MC. \| last2 = Secades \| first2 = AL. \| last3 = Angulo \| first3 = JM. \| title = Best cases from the AFIP: intracystic papillary carcinoma of the breast. \| journal = Radiographics \| volume = 30 \| issue = 7 \| pages = 2021-7 \| month = Nov \| year = 2010 \| doi = 10.1148/rg.307105003 \| PMID = 21057133 \| URL = http://radiographics.rsnajnls.org/cgi/pmidlookup?view=long&pmid=21057133 }}</ref>

			==Microscopic==
			Features:
			*Lesion confined to a cyst.
			**May have a thick fibrous capsule
			**The involved space is ''not'' lined by myoepithelial cells.
			*The cyst contains an abnormal epithelial proliferation with cribriform, solid or papillary architecture.
			**Loss of myoepithelial cells within the epithelial proliferation is a '''key feature'''.
			**Scattered large cells with pale eosinophilic cytoplasm may be observed<ref>{{Cite journal \| last1 = Collins \| first1 = LC. \| last2 = Schnitt \| first2 = SJ. \| title = Papillary lesions of the breast: selected diagnostic and management issues. \| journal = Histopathology \| volume = 52 \| issue = 1 \| pages = 20-9 \| month = Jan \| year = 2008 \| doi = 10.1111/j.1365-2559.2007.02898.x \| PMID = 18171414 }}
			</ref>.
			***These cells are so-called globoid cells or clear cells and are immunoreactive for GCDFP-15.
			***They should not be mistaken for myoepithelial cells.
			**Neoplastic epithelial cells:
			***[[Nuclear atypia]] - including: nucleoli, [[nuclear pleomorphism]].

			Notes:
			*Many potential pitfalls with papillary breast lesions on needle core biopsy.
			**Complete excision is recommended<ref>{{Cite journal \| last1 = Rizzo \| first1 = M. \| last2 = Linebarger \| first2 = J. \| last3 = Lowe \| first3 = MC. \| last4 = Pan \| first4 = L. \| last5 = Gabram \| first5 = SG. \| last6 = Vasquez \| first6 = L. \| last7 = Cohen \| first7 = MA. \| last8 = Mosunjac \| first8 = M. \| title = Management of papillary breast lesions diagnosed on core-needle biopsy: clinical pathologic and radiologic analysis of 276 cases with surgical follow-up. \| journal = J Am Coll Surg \| volume = 214 \| issue = 3 \| pages = 280-7 \| month = Mar \| year = 2012 \| doi = 10.1016/j.jamcollsurg.2011.12.005 \| PMID = 22244207 }}</ref>.
			*Adequately and carefully sample the specimen to exclude an invasive component.
			*Report only the size of the invasive component (if present) to prevent over-estimation of tumor stage.

			DDx<ref>{{Cite journal \| last1 = Collins \| first1 = LC. \| last2 = Schnitt \| first2 = SJ. \| title = Papillary lesions of the breast: selected diagnostic and management issues. \| journal = Histopathology \| volume = 52 \| issue = 1 \| pages = 20-9 \| month = Jan \| year = 2008 \| doi = 10.1111/j.1365-2559.2007.02898.x \| PMID = 18171414 }}
			</ref><ref>{{Cite journal \| last1 = Pathmanathan \| first1 = N. \| last2 = Albertini \| first2 = AF. \| last3 = Provan \| first3 = PJ. \| last4 = Milliken \| first4 = JS. \| last5 = Salisbury \| first5 = EL. \| last6 = Bilous \| first6 = AM. \| last7 = Byth \| first7 = K. \| last8 = Balleine \| first8 = RL. \| title = Diagnostic evaluation of papillary lesions of the breast on core biopsy. \| journal = Mod Pathol \| volume = 23 \| issue = 7 \| pages = 1021-8 \| month = Jul \| year = 2010 \| doi = 10.1038/modpathol.2010.81 \| PMID = 20473278 }}</ref>:
			*[[Intraductal papilloma]].
			**Absent or scant stroma favors papillary carcinoma over papilloma.
			**Is there a single cell or dual cell population in the lesion?
			***ER staining will be heterologous in a benign lesion.
			***Myoepithelial markers (calponin/p63/SMA +ve)s hould be positive in a benign lesion.
			*[[Papillary ductal carcinoma in situ]]
			**Papillary DCIS shows myoepithelial cells (calponin/p63/SMA +ve) at the periphery of the involved spaces
			**But papillary DCIS should be negative for myoepithelial cells within the focus of DCIS
			**Papillary intracystic carcinoma does not show myoepithelial cells at the periphery of the involved spaces
			*Invasive papillary carcinoma of the breast
			**Similar architecture but no cystic space, frankly invasive.
			**Very rare.
			*Invasive carcinoma arising in association with papillary intracystic carcinoma
			**Epithelial entrapment in the encysting fibrous tissue should not be interpreted as invasion.
			**Carcinoma must be seen in the breast tissue outside the encysting fibrous tissue.
			**Infiltrating carcinoma is usually of the 'no special type' variety.
			*[[Adenoid cystic carcinoma of the breast]]
			**The solid variant looks basaloid - solid adenoid cystic carcinoma or a 'basal-like' carcinoma should be considered in these cases.

			===Images===
			<gallery>
			Image:Breast PapillaryCarcinomaEncysted 3 PA.JPG\|Breast - Intracystic Papillary Carcinoma - Medium power (SKB)
			Image:Breast PapillaryCarcinomaEncysted 2 PA.JPG\|Breast - Intracystic Papillary Carcinoma - Medium power (SKB)
			Image:Breast PapillaryCarcinomaEncysted PA.JPG\|Breast - Intracystic Papillary Carcinoma - High power (SKB)
			Image:Breast Carcinoma Papillary Intracystic SolidVariant LP CTR.jpg\|Breast - Papillary Intracystic Carcinoma, Solid Variant - low power (SKB)
			Image:Breast Carcinoma Papillary Intracystic SolidVariant MP2 CTR.jpg\|Breast - Papillary Intracystic Carcinoma, Solid Variant - medium power (SKB)
			Image:Breast Carcinoma Papillary Intracystic SolidVariant MP CTR.jpg\|Breast - Papillary Intracystic Carcinoma, Solid Variant - medium power (SKB)
			Image:Breast Carcinoma Papillary Intracystic SolidVariant HP2 CTR.jpg\|Breast - Papillary Intracystic Carcinoma, Solid Variant - high power (SKB)
			Image:Breast Carcinoma Papillary Intracystic SolidVariant HP CTR.jpg\|Breast - Papillary Intracystic Carcinoma, Solid Variant - high power (SKB)
			Image:Breast EncystedPapillaryCarcinoma InfiltratingDuctalCarcinoma PA.JPG\|Breast - Intracystic papillary adenocarcinoma (top) with associated invasive ductal carcinoma (bottom) (SKB)
			</gallery>

			==IHC==
			*Calponin/p63/SMA/CK5-6.
			**Loss of myoepithelial cells within the tumour.
			**Loss of myoepithelial cells at the cyst wall.
			*ER - Homogeneous staining of the epithelial proliferation.

			==References==
			{{Reflist\|2}}

			[[Category:Diagnosis]]
			[[Category:Invasive breast cancer]]

Michael: redirect

2012-01-10T18:39:01Z

redirect

← Older revision		Revision as of 18:39, 10 January 2012
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	#redirect [[~~intracystic papillary carcinoma of the breast~~]]		#redirect [[Invasive_breast_cancer#Invasive_papillary_carcinoma_of_the_breast]]

Michael: redirect

2012-01-10T18:38:28Z

redirect

New page

#redirect [[intracystic papillary carcinoma of the breast]]