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Piernicola Machin Anatomia Patologica P.O. De Gironcoli Conegliano Resp. dott.ssa Lucia Bittesini.

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Presentation on theme: "Piernicola Machin Anatomia Patologica P.O. De Gironcoli Conegliano Resp. dott.ssa Lucia Bittesini."— Presentation transcript:

1 Piernicola Machin Anatomia Patologica P.O. De Gironcoli Conegliano Resp. dott.ssa Lucia Bittesini

2 L.D., 50 anni,microcalcificazioni QIE dx

3

4 EE 10x

5

6 EE 20x

7 EE 40x

8 EE 20x

9 EE 40x

10 B2 B3 B5 B2 B3 B5

11 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)

12 QUADRANTECTOMIA + LINFONODO SENTINELLA + SVUOTAMENTO LINFONODALE

13

14 EE 5x

15 EE 10x

16 EE 40x

17

18

19 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)

20 Follow-up

21 PatologoRadiologo ChirurgoOncologo

22 GRAZIE

23

24 B2B3

25 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.

26 122 biopsie(B3) 91 sintomatiche31 screening 1845 biopsie in 3 anni FEA 18% ADH 90%B10%M 90%B ESCISSIONE

27 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


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