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Archives of Pathology & Laboratory... Jan 2020Microglandular adenosis is a rare borderline neoplastic lesion of the breast composed of haphazardly located small, round tubules with a single cell layer interspersed... (Review)
Review
CONTEXT.—
Microglandular adenosis is a rare borderline neoplastic lesion of the breast composed of haphazardly located small, round tubules with a single cell layer interspersed within breast stroma and/or adipose tissue. Microglandular adenosis is devoid of a myoepithelial cell layer, and has a characteristic immunophenotype, being positive for S100 and negative for estrogen receptor, progesterone receptor, and HER2/. When associated with cancer, microglandular adenosis and associated invasive carcinoma share the same molecular alterations, including mutation; therefore, microglandular adenosis is considered a nonobligate precursor of triple (HER2/, estrogen and progesterone receptors)-negative breast carcinoma. Microglandular adenosis is an important diagnostic pitfall as it can be easily mistaken for a low-grade invasive carcinoma.
OBJECTIVE.—
To provide a review of the clinicopathologic features of microglandular adenosis and associated invasive carcinoma, with emphasis on key features separating entities in the differential diagnosis.
DATA SOURCES.—
Review of current literature on microglandular adenosis and associated invasive carcinoma and personal experience of authors.
CONCLUSIONS.—
Microglandular adenosis can mimic breast carcinoma; attention to key features, including morphologic-immunophenotypic correlation, is essential in establishing the diagnosis.
Topics: Breast Neoplasms; Female; Fibrocystic Breast Disease; Humans; Precancerous Conditions; Triple Negative Breast Neoplasms
PubMed: 31116044
DOI: 10.5858/arpa.2019-0049-RA -
Head & Neck Sep 2023In this systematic review, we aimed to evaluate the clinicopathological profile of sclerosing polycystic adenoma (SPA). PubMed, Scopus, EMBASE, Lilacs, Web of Science,... (Review)
Review
In this systematic review, we aimed to evaluate the clinicopathological profile of sclerosing polycystic adenoma (SPA). PubMed, Scopus, EMBASE, Lilacs, Web of Science, and gray literature were searched to access cases of SPA in salivary glands. One hundred and thirty cases of SPA were found across 61 selected articles. SPA affected mainly the parotid gland of adults with a mean age of 44.6 years old, with a slight preference for females. The lesion was usually presented as a painless firm mass with a long period of evolution. Histologically, they are well-delimitated lesions composed of acinar and ductal elements with a variety of cytomorphologic features surrounded by a densely collagenized stroma. PI3K was the most common gene mutation related to SPA. SPA is a benign condition that mainly affects the parotid gland of female patients and it is usually treated by surgical resection with a good prognosis.
Topics: Adult; Humans; Female; Parotid Gland; Adenoma; Sclerosis
PubMed: 37403748
DOI: 10.1002/hed.27435 -
Archives of Pathology & Laboratory... Oct 2016Apocrine change in the breast is an extremely common finding. In most cases, the benign or malignant nature of the lesion is easily recognized. Apocrine adenosis is used... (Review)
Review
Apocrine change in the breast is an extremely common finding. In most cases, the benign or malignant nature of the lesion is easily recognized. Apocrine adenosis is used to describe sclerosing adenosis with apocrine change. The term apocrine atypia is used when there is significant cytologic atypia in apocrine cells, characterized by a 3-fold nuclear enlargement, prominent/multiple nucleoli, and hyperchromasia. Atypical apocrine adenosis is diagnosed when apocrine adenosis and apocrine atypia are superimposed. However, there are no definite criteria to distinguish atypical apocrine adenosis from apocrine ductal carcinoma in situ. Immunohistochemical markers can be confounding and may lead to erroneous diagnoses. Atypical apocrine features in sclerosing lesions may be misinterpreted as invasive carcinoma if the underlying lesion is not recognized. In the absence of definite features of malignancy, the diagnosis of apocrine ductal carcinoma in situ may be extremely difficult. In the present article, we review atypical apocrine adenosis focusing on diagnostic challenges and their implications on clinical management.
Topics: Apocrine Glands; Breast; Carrier Proteins; Diagnosis, Differential; Female; Fibrocystic Breast Disease; Glycoproteins; Humans; Immunohistochemistry; Membrane Transport Proteins; Metaplasia; Precancerous Conditions
PubMed: 27684975
DOI: 10.5858/arpa.2016-0238-RA -
Human Pathology Dec 2018Microglandular adenosis (MA) of the breast, a benign glandular proliferation, was originally described approximately 35 years ago. The lesion is constituted by small... (Review)
Review
Microglandular adenosis (MA) of the breast, a benign glandular proliferation, was originally described approximately 35 years ago. The lesion is constituted by small glands, all of the same size. Glands are lined by one layer of cuboidal epithelial cells encircled by basal lamina without any evidence of interposed myoepithelial elements. Cells are positive for low-weight keratins and S-100 protein and negative for estrogen receptor, progesterone receptor, and HER-2. Since then, in the years that followed, several malignant lesions all showing microglandular architecture have been regarded either as a precursor or as an equivalent manifestation of MA. The latter has been associated with a large number of malignancies that include ductal carcinoma in situ, lobular carcinoma in situ, ademyoepithelioma, high-grade basal-like carcinoma, adenoid cystic carcinoma, matrix-producing carcinoma, invasive duct carcinoma not otherwise specified, and spindle cell carcinoma, not to mention acinic cell carcinoma. None of the above tumors were identical to MA. Differences mainly rested not only on the specific structure of the small glands but also on the cytological composition and immunohistochemical features of different lesions. Here, a review of the features of MA together with the differential diagnosis with lesions showing microglandular structure is discussed. MA shows similarities to a lesion named microglandular hamartoma/adenosis of the nasal cavity. The relation of the 2 similar lesions is discussed.
Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Biopsy; Breast Neoplasms; Cell Proliferation; Diagnosis, Differential; Female; Fibrocystic Breast Disease; Humans; Immunohistochemistry; Mammary Glands, Human; Middle Aged; Precancerous Conditions; Predictive Value of Tests
PubMed: 29949742
DOI: 10.1016/j.humpath.2018.06.025 -
The American Journal of Surgical... Sep 1994Adenosis (atypical adenomatous hyperplasia, small gland hyperplasia) of the prostate is characterized by a relatively well-circumscribed proliferation of benign glands... (Review)
Review
Adenosis (atypical adenomatous hyperplasia, small gland hyperplasia) of the prostate is characterized by a relatively well-circumscribed proliferation of benign glands that frequently mimics low-grade adenocarcinoma. Although general reviews of adenosis exist, relatively few specialized studies have characterized the histologic features of adenosis. The purpose of this study was to review and better document the histologic features of adenosis. Forty-four transurethral resection (TUR) specimens containing a total of 145 foci of adenosis were evaluated for the presence or absence of six histologic features: mitotic figures, blue-tinged luminal mucinous secretions, intraluminal crystalloids, single cells, a focally infiltrative growth pattern, and prominent nucleoli. Immunohistochemical stains for high-molecular-weight cytokeratin were performed on 66 (46%) of the foci to confirm the presence of a basal cell layer and thus the diagnosis of adenosis. Crystalloids were present in 58 foci (40%), an infiltrative growth pattern in 27 foci (19%), single cells in 23 foci (16%), prominent nucleoli in 22 foci (15%), mitotic figures in 16 foci (11%), and blue-tinged luminal mucinous secretions in 3 foci (2%). The diagnosis of adenosis is based on a constellation of histologic features and may be confirmed with the use of antibodies to high-molecular-weight cytokeratin.
Topics: Adenocarcinoma; Aged; Aged, 80 and over; Diagnosis, Differential; Humans; Male; Middle Aged; Prostatectomy; Prostatic Hyperplasia; Prostatic Neoplasms
PubMed: 7520673
DOI: 10.1097/00000478-199409000-00001 -
Arkhiv Patologii 2023The presented case describes the difficulties of diagnosis of the breast microglandular adenosis (MGA), taken by clinicians for a malignant process due to the nature of...
The presented case describes the difficulties of diagnosis of the breast microglandular adenosis (MGA), taken by clinicians for a malignant process due to the nature of growth and large size. Criteria for histological and immunohistochemical diagnosis and differentiation of MGA with malignant neoplasms, in particular, with tubular breast carcinoma, are presented. Taking into account the rarity of the pathology and the absence of described cases in the Russian-language literature, the observation is of interest to pathologists and clinicians.
Topics: Female; Humans; Fibrocystic Breast Disease; Immunohistochemistry; Carcinoma, Ductal, Breast; Diagnosis, Differential; Breast Neoplasms
PubMed: 37053352
DOI: 10.17116/patol20238502140 -
American Journal of Men's Health 2022Sclerosing adenosis of the prostate (SAP) is a rare benign non-neoplastic small acinar hyperplasia. Like sclerosing adenosis of the breast, which is confused with breast... (Review)
Review
Sclerosing adenosis of the prostate (SAP) is a rare benign non-neoplastic small acinar hyperplasia. Like sclerosing adenosis of the breast, which is confused with breast cancer, SAP is a trap in the pathological differential diagnosis of benign and malignant lesions of the prostate. We report such a case to help colleagues better distinguish and diagnose such diseases. A 75-year-old patient with SAP had a prostate specific antigen (PSA) level of 11.0 ng/mL, and he had been suffering from progressive dysuria for 3 years. The central glandular area and the right periphery of the prostate were found to have nodular low signals on magnetic resonance imaging (MRI). Prostate biopsy showed that basal cells were positive for P63 and P504s, few basal cells were positive for S-100, and the positive rate of Ki67 was approximately 2%. We consider that the possibility of SAP is high. The patient was treated conservatively and was discharged in good health, free of dysuria and other problems. SAP is a rare benign lesion that is easily misdiagnosed as prostate cancer. The prostatic gland tube has a complete basal cell layer surrounding it, as well as myoepithelial cell metaplasia of basal cells, which is a key trait in distinguishing it from prostate cancer. Although the latest research indicates that SAP does not require treatment, the question of whether it is a risk factor for prostate cancer remains unanswered.
Topics: Male; Humans; Aged; Prostate; Prostatic Hyperplasia; Dysuria; Prostatic Neoplasms; Diagnosis, Differential
PubMed: 36527372
DOI: 10.1177/15579883221143182 -
Indian Journal of Pathology &... 2019Sclerosing polycystic adenosis (SPA) is primarily a disease of major salivary glands. It was recognized as a distinct morphologic entity by Smith et al. in 1996. To best... (Review)
Review
Sclerosing polycystic adenosis (SPA) is primarily a disease of major salivary glands. It was recognized as a distinct morphologic entity by Smith et al. in 1996. To best of our knowledge, 67 cases of SPA are reported in English literature. Here, we describe a case of SPA showing classic histomorphological features, involving the parotid gland of a 17-year-old girl. It was diagnosed as mucoepidermoid carcinoma at a peripheral hospital and was referred to our center. Histologically, it was well circumscribed and composed of lobules, separated by hyalinized stroma. Lobules showed adenosis, foci of acinic cell hyperplasia, and intraductal epithelial proliferation. Immunohistochemistry with p63 highlighted myoepithelial layer around every duct, acinus, and also in foci showing epithelial hyperplasia. There was no evidence of malignancy. Awareness of SPA, a benign rare entity, is essential to avoid misdiagnosing it as other common salivary gland tumors which it may mimic.
Topics: Adolescent; Carcinoma, Mucoepidermoid; Cysts; Female; Humans; Hyperplasia; Immunohistochemistry; Parotid Gland; Salivary Gland Neoplasms; Sclerosis; Ultrasonography
PubMed: 30706879
DOI: 10.4103/IJPM.IJPM_518_17 -
World Journal of Surgery 1989The literature regarding sclerosing adenosis has been reviewed. The pathological and radiological aspects of this benign breast condition have been emphasized since they...
The literature regarding sclerosing adenosis has been reviewed. The pathological and radiological aspects of this benign breast condition have been emphasized since they influence clinical practice. Features of 43 patients diagnosed as having sclerosing adenosis have been reported. Cancer was suspected on mammography in 17, and 25 experienced breast pain. Thus, the lesion is important both as a mimic of malignancy and as a cause of mastalgia. The clinical and radiological features allow the condition to be suspected before biopsy, in which circumstance paraffin histology is greatly preferable to frozen section.
Topics: Adult; Aged; Breast; Breast Neoplasms; Diagnosis, Differential; Female; Fibrocystic Breast Disease; Humans; Middle Aged; Radiography
PubMed: 2623882
DOI: 10.1007/BF01658421 -
Cytological diagnosis of sclerosing adenosis of breast: Diagnostic challenges and literature review.Cytopathology : Official Journal of the... Nov 2021
Review
Topics: Adult; Breast; Breast Neoplasms; Cytodiagnosis; Diagnosis, Differential; Female; Fibrocystic Breast Disease; Humans
PubMed: 34293209
DOI: 10.1111/cyt.13041