Wednesday, December 22, 2010

Fibroadenoma

Fibroadenomas, which are generally firm, smooth, and round, can be readily moved under the skin and are often described as feeling similar to marbles. Typically the masses measure from 1 to 3 centimeters in size, but occasionally they may grow much larger, in which case they are termed giant fibroadenomas. Fibroadenomas, which arise from the intralobular stroma, are solid and consist of a combination of glandular and fibrous tissues. The tumors are usually painless and present no symptoms, typically being discovered by young women only due to self-examination. In older women, fibroadenomas are often less palpable and may first be discovered during a routine mammogram.

Fibroadenomas showing circumscribed margins, even distribution of epithelial and stromal components and low stromal cellularity.
-Low power scanning of Fibroadenoma :
# Use low power scanning to determine:
  •  the basic pattern - pericanalicular or intracanalicular
  •  edge of lesion (pushing or infiltrative) - should be pushing
  •  balance between stroma and epithelium - should be even
  •  to pick out areas of stromal hypercellularity



# The stroma can be cellular particularly in younger patient's lesions - but it's usually uniform

# The occasional stromal mitosis is acceptable in a younger patient's lesion but take advice

# Uneven stromal cellularity in a core biopsy may be a pointer to a Phyllodes Tumour

You can suspect Phyllodes Tumour if:
* Patient older than 40 years
* Lesion larger than 4 cm
* History of recent growth

Labels: ,