Difficult Diagnoses in Breast Pathology

259 Pages·2011·87.023 MB·English

by  Juan P. Palazzo MD

DIFFICULT
DIAGNOSES IN
BREAST
PATHOLOGY
About the Editor
Juan P. Palazzo
Recommended
Shelving Category:
Pathology
Difficult Diagnoses in Breast
Pathology

Difficult Diagnoses in Breast
Pathology
EDITED BY
Juan P. Palazzo, MD
Department of Pathology
Thomas Jefferson University
Philadelphia, Pennsylvania
New York
ISBN: 978-1-933864-79-2
eBook ISBN: 978-1-935281-30-6
Acquisitions Editor: Richard Winters
Production Editor: Dana Bigelow
Compositor: Manila Typesetting Company
Printer: SCI
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Library of Congress Cataloging-in-Publication Data
Difficult diagnoses in breast pathology / edited by Juan P. Palazzo.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-933864-79-2
1. Breast—Diseases—Diagnosis. 2. Tumor markers. I. Palazzo, Juan P.
[DNLM: 1. Breast—pathology. 2. Biopsy, Fine-Needle. 3. Breast Diseases—diagnosis.
4. Tumor Markers, Biological. WP 840]
RG493.D547 2011
618.1’9—dc22
2011008921
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11 12 13 14 15 5 4 3 2 1
Contents
Preface vii
Contributors ix
1 T he Diagnostic Challenges of Core Needle Biopsy 7 Carcinomas With Good Prognosis 146
Interpretation 2 Melinda E. Sanders
Aylin Simsir and Joan F. Cangiarella
8 Mesenchymal Lesions of the Breast 172
2 M orphologic Precursors of Mammary Carcinoma Melinda E. Sanders, John S. J. Brooks, and
and Their Mimics 24 Juan P. Palazzo
Edi Brogi, Adriana D. Corben, and Melissa P. Murray
9 Lymphomas of the Breast 196
3 P apillary Lesions of the Breast 56 Judith A. Ferry
Cansu Karakas, Erika Resetkova, and
Aysegul A. Sahin 10 I mmunohistochemistry in Breast Pathology 212
Felipe C. Geyer, Magali Lacroix-Triki, and
4 F lat Epithelial Atypia 88 Jorge S. Reis-Filho
Melinda F. Lerwill
Index 243
5 A denosis: Mimickers of Carcinoma 114
Juan P. Palazzo and José Palacios Calvo
6 M icroinvasive Carcinoma: Diagnosis and
Pitfalls 128
Dilip Giri

Preface
The goal of this book is to provide pathologists with I was very fortunate to have worked with such an out-
a reference guide to use in the diagnosis and dif- standing group of experts in the field. Without their great
ferential diagnosis of common and uncommon breast dedication and effort this book would not have been pos-
diseases. sible. Each chapter reflects the authors, own experience
The role of the pathologist has become very important in practice and the best guide to solve problem cases from
in the diagnosis and management of patients with breast their own perspective.
diseases. Pathologists are frequently asked to make diag- My hope is that this book provides information that
nosis in small samples and are faced with difficult deci- will help pathologists with the interpretation of breast
sions in their daily practice. biopsies and will also be a source of education for resi-
The book is organized into chapters devoted to the dents and fellows, as well as other physicians interested in
challenges in the diagnosis of breast diseases using core breast disorders.
biopsies and chapters dedicated to specific epithelial I want to thank all my colleagues from the Department
and mesenchymal lesions, lymphoid proliferations, and of Pathology of Jefferson University for sharing breast
immunohistochemistry. cases with me. Mr. Richard Winters from Demos Medical
This is a book that primarily emphasizes the diag- Publishing for his patience and valuable advice and
nostic morphologic features. The text highlights the most Christopher Braster from Jefferson University for help
important aspects of each entity with a particular focus with the photographs. My entire family for the relentless
in the diagnostic criteria, differential diagnosis, immuno- support in all my endeavors.
histochemical findings, and management. Tables and key
points are included in each chapter to summarize the most
important findings. Juan P. Palazzo

Contributors
Edi Brogi, MD, PhD Felipe C. Geyer, MD
Associate Professor of Pathology The Breakthrough Breast Cancer Research Centre
Weill Cornell Medical College Institute of Cancer Research
Associate Attending Pathologist London, United Kingdom
Memorial Sloan-Kettering Cancer Center
New York, New York
Dilip Giri, MD, FACP
Associate Attending Pathologist
John S. J. Brooks, MD, FRCPath Memorial Sloan Kettering Cancer Center
Professor of Pathology and Laboratory Medicine New York, New York
University of Pennsylvania Health System
Chair, Department of Pathology
Pennsylvania Hospital
Cansu Karakas, MD
Philadelphia, Pennsylvania
Experimental Radiation Oncology
The University of Texas MD Anderson Cancer Center
Houston, Texas
José Palacios Calvo, MD, PhD
Department of Pathology
Virgen del Rocio University Hospital and
Magali Lacroix-Triki, MD
Institute for Biomedical Research of Seville (IBIS)
The Breakthrough Breast Cancer Research Centre
Seville, Spain
Institute of Cancer Research
London, United Kingdom
Joan F. Cangiarella, MD
Associate Professor of Pathology
Melinda F. Lerwill, MD
Vice-Chair of Clinical Operations
Assistant Professor of Pathology
Department of Pathology
Harvard Medical School
New York University School of Medicine
The James Homer Wright Pathology Laboratories
New York, New York
Massachusetts General Hospital
Boston, Massachusetts
Adriana D. Corben, MD
Assistant Attending Pathologist
Memorial Sloan-Kettering Cancer Center Melissa P. Murray, DO
New York, New York Assistant Attending Pathologist
Memorial Sloan-Kettering Cancer Center
New York, New York
Judith A. Ferry, MD
Associate Professor of Pathology
Harvard Medical School Juan P. Palazzo, MD
Director of Hematopathology Professor
The James Homer Wright Pathology Laboratories Department of Pathology
Massachusetts General Hospital Thomas Jefferson University
Boston, Massachusetts Philadelphia, Pennsylvania