Mucocele-like tumor (MLT) of the breast is a rare neoplasm. Although this lesion was considered benign when first described, the concept of a pathologic continuum with mucinous carcinoma was evident in subsequent reports. Only a few cases of MLT have been reported in Korea. We describe a case of MLT associated with ductal carcinoma in situ and mucinous carcinoma in a 34-yr-old female. Histological examination showed multiple mucus-filled cysts of varying size. Extravasated mucin was present in the surrounding stroma. The lining of the cysts in most areas were of flat or cuboidal epithelium and devoid of cellular atypia. The lining epithelium showed proliferative change ranging from atypical ductal hyperplasia to ductal carcinoma in situ, micropapillary type. A microscopic focus of mucinous carcinoma within MLT was also noted. None of the lesions exhibited epithelial reactivity for p53 protein. The patient is alive and well without evidence of disease 54 months after initial treatment. This case supports the concept that MLT encompasses a spectrum of pathologic lesions including benign tumor, atypical ductal hyperplasia, ductal carcinoma in situ, and mucinous carcinoma.
Adenocarcinoma, Mucinous/*pathology ; Adult ; Breast Neoplasms/*pathology ; Carcinoma in Situ/*pathology ; Carcinoma, Infiltrating Duct/*pathology ; Diagnosis, Differential ; Female ; Human ; Mucocele/*pathology

Breast/pathology* ; Breast Neoplasms/pathology* ; Carcinoma in Situ/pathology* ; Carcinoma, Lobular/pathology* ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia/pathology*

OBJECTIVETo observe and summarize the morphologic features that may suggest submucosal invasive adenocarcinoma in colorectal mucosa biopsy specimens.

METHODSThe study cohort included 432 colorectal biopsy specimens were obtained from 2006 to 2012. All the cases had radical surgery. Basing on the pathologic diagnoses, the cases were divided into 366 invasive adenocarcinoma (IAC) and 66 high-grade intraepithelial neoplasms (HGIN). These two groups were compared.

RESULTSIn the IAC group, the percentage of tumor forming cribriform structures, acute angle-shaped glands, diffuse carcinoma cell proliferation was 61.2% (224/366) , 33.8% (124/366) and 7.4% (27/366) , respectively. In the HGIN group, cribriform gland structures appeared in 6.0% (4/66) of the cases, while no acute angle-shaped gland or diffuse carcinoma cell proliferation was detected. The difference of these three characteristics in the two group was statistically significant (all P < 0.01). Glandular branching was detected in 89.9% (329/366) of IAC cases and 66.7% (44/66) of HGIN cases; this difference was not significant. There was no difference in cellular atypia between the two groups. Interstitial fibrosis was detected more frequently in the IAC group (85.5%, 313/366 in IAC versus 0 in HGIN, P < 0.01). In biopsy specimens of IAC, a few cases showed neoplastic glands in close contact with large lymphatics, adipose tissue, and ganglion.

CONCLUSIONSIn colorectal biopsy specimen, the five features that suggest submucosal invasion of the neoplastic glands including the formation of cribriform structure, angular gland, diffuse carcinoma cells, interstitial fibrosis and neoplastic glands in close contact with the thick-walled vessels.

Adenocarcinoma ; pathology ; Biopsy ; Carcinoma in Situ ; pathology ; Cell Proliferation ; Diagnosis, Differential ; Humans ; Intestinal Mucosa ; pathology ; Neoplasm Invasiveness

Carcinoma in Situ ; diagnosis ; pathology ; Cervical Intraepithelial Neoplasia ; diagnosis ; pathology ; Endometrial Hyperplasia ; pathology ; Female ; Humans ; Uterine Cervical Neoplasms ; pathology

Carcinoma in Situ ; diagnosis ; pathology ; surgery ; Carcinoma, Transitional Cell ; diagnosis ; pathology ; surgery ; Cystectomy ; Humans ; Neoplasm Invasiveness ; Neoplasm Staging ; methods ; Urinary Bladder ; pathology ; surgery ; Urinary Bladder Neoplasms ; diagnosis ; pathology ; surgery

OBJECTIVETo study the clinical and pathological features of mucocele-like lesions in the breast.

METHODSNine cases of mucocele-like lesions in the breast were reported for the morphological and immunohistochemical features, the differential diagnosis, and a literature review.

RESULTSAll nine cases were from female patients, aged 23 to 43 years (mean 34 years), clinically presented with palpable breast masses. Grossly, the lesions were multi-cystic with colloidal appearances. Histologically, the lesions consisted of multiple cysts filled with colloid, these cysts were lined with tubular, cuboidal or columnar epithelium. There were superimposed papillary epithelial hyperplasia in three cases and atypical ductal hyperplasia in one. Extravasated mucinous lakes were seen in the stroma, but without cellular component.

CONCLUSIONMucocele-like lesions of the breast is a group of mostly benign disease, and the differential diagnosis should include mucinous carcinoma.

Adenocarcinoma, Mucinous ; diagnosis ; pathology ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; pathology ; Carcinoma in Situ ; diagnosis ; Carcinoma, Ductal, Breast ; diagnosis ; pathology ; Diagnosis, Differential ; Female ; Gene Expression Regulation, Neoplastic ; physiology ; Humans ; Hyperplasia ; pathology ; Intestinal Neoplasms ; pathology ; Mucocele ; diagnosis ; pathology

Biopsy, Fine-Needle ; Bronchoalveolar Lavage Fluid ; Bronchoscopy ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; pathology ; Humans ; In Situ Hybridization, Fluorescence ; Lung Neoplasms ; diagnosis ; pathology ; Small Cell Lung Carcinoma ; diagnosis ; pathology

Carcinoma in Situ ; pathology ; Carcinoma, Squamous Cell ; classification ; pathology ; Cervical Intraepithelial Neoplasia ; classification ; pathology ; Diagnosis, Differential ; Female ; Humans ; Precancerous Conditions ; classification ; pathology ; Uterine Cervical Neoplasms ; classification ; pathology

Bile Duct Neoplasms ; etiology ; pathology ; Bile Ducts, Intrahepatic ; pathology ; Carcinoma in Situ ; etiology ; pathology ; Carcinoma, Papillary ; pathology ; Cholangitis, Sclerosing ; complications ; Diagnosis, Differential ; Humans ; Precancerous Conditions ; etiology ; pathology

OBJECTIVETo compare the effectiveness and accuracy of the use of vacuum-assisted biopsy (VAB) versus wire localization (WL) in the diagnosis of non-palpable breast lesions (NPBL).

METHODSNinety-seven consecutive women with NPBL were randomized into VAB group and WL group. All specimens were identified by mammography. The patients were requested to score the cosmetic appearance of their breast after operation, and a numerical rating scale was used to measure pain on the first postoperative day. Underestimation rates for atypical ductal hyperplasia (ADH) and ductal carcinoma in situ (DCIS) were recorded if open surgical biopsy revealed DCIS and invasive cancer, respectively. Clear margins were also recorded in the two groups.

RESULTSVAB and WL located all the NPBL successfully. In the VAB group, the specimen volume was smaller than that of the WL group (2.3 cm(3) vs. 18.4 cm(3), P = 0.03). Underestimation rates of ADH and DCIS in the VAB group were 16.7% and 11.1%, respectively. The diagnostic accordance rate of VAB was 97.9%, the false negative rate was 2.1%, and there was no false positive case. The means of the numerical rating pain scale were different in both groups (1.7 for VAB vs. 2.5 for WL, P = 0.02). When cosmetic results were taken into account, 40 VAB patients had excellent outcomes and 8 good outcomes, compared with 25 excellent and 24 good for the WL group. There were better cosmetic outcomes with the VAB procedure (P < 0.05).

CONCLUSIONVAB is highly reliable and may avoid diagnostic open surgery in the majority of patients with benign lesions. However, because of the underestimation of histologic diagnosis and tumor margin involvement, VAB can not be used to completely substitute wire localization.

Adult ; Biopsy, Needle ; instrumentation ; methods ; Breast ; pathology ; Breast Neoplasms ; diagnosis ; pathology ; Carcinoma in Situ ; diagnosis ; pathology ; Carcinoma, Ductal, Breast ; diagnosis ; pathology ; Diagnostic Errors ; Female ; Fibroadenoma ; diagnosis ; pathology ; Humans ; Hyperplasia ; Middle Aged ; Precancerous Conditions ; diagnosis ; pathology ; Stereotaxic Techniques ; instrumentation ; Vacuum