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Pathology of Breast Cancer
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Atypical hyperplasia is indeed a diagnostic challenge for a pathologist. This entity defines a noninfiltrating breast abnormality with some, but not all, of the features of cancer. Atypical hyperplasia occupies an intermediate position between benign and malignant lesions. The differentiation between atypical hyperplasia and low-grade ductal carcinoma in situ has major clinical implications, and yet truly reproducible morphologic criteria to ascertain the correct diagnosis are not present.
EMQ Answers
Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
T Total abdominal hysterectomy and bilateral salpingo-ophorectomyThe treatment for this patient is a hysterectomy and bilateral salpingo-oophorectomy. However, this needs to be performed by open surgery as morcellation is not recommended in patients with atypical hyperplasia. This is due to the risk of disseminating malignancy. Supracervical hysterectomy should also not be performed. (Management of Endometrial Hyperplasia. The Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 67, February 2016)
The Ultrastructure And Pathobiology Of Urinary Bladder Cancer
Published in George T. Bryan, Samuel M. Cohen, The Pathology of Bladder Cancer, 2017
Bendicht U. Pauli, Joseph Alroy, Ronald S Weinstein
Atypical hyperplasia and its more severe form, dysplasia, differ from simple hyperplasia in that there are significant nuclear atypicalities. Atypical hyperplasia is usually subclassified as mild, moderate, or severe based upon the degree of cellular atypicality and the proportion of atypical cells.2,3,145,170,171 The atypical cells have altered nuclear/cytoplasmic ratios, demonstrate pleomorphism, and frequently show loss of cell polarity. Thus, they exhibit some of the morphological changes of malignant cells. The nuclei vary from small round shapes with extensive chromatin clumping, to large hyperchromatic nuclei with evenly dispersed chromatin and large, often multiple nucleoli.171 As seen in scanning electron micrographs, the superficial layer of umbrella cells in normal bladder epithelium is partially preserved in dysplasia, although the cobblestone-like surface pattern is often interrupted by foci of small, spheroid cells.145,171 While cells in the cobblestone areas are covered by microridges, the small spheroid cells are covered by numerous pleomorphic microvilli. Except for these nuclear alterations, the cytoarchitecture of the cells in dysplasia is similar to that of the cells in simple hyperplasia. In dysplasia, mitotic activity is increased in both the basal cell layer and the intermediate cell layer.
Preliminary dynamic observation of wound healing after low-temperature plasma radiofrequency ablation for laryngeal leukoplakia
Published in Acta Oto-Laryngologica, 2022
Fang Hao, Liyan Yue, Xiaoyan Yin, Chunguang Shan
Currently, the 2005 WHO histopathologic classification is the most widely used classification of precancerous lesions [2]. The WHO classification is based on the degree or extent of epithelial dysplasia, as follows [2]: hyperplasia; mild dysplasia; moderate dysplasia; severe dysplasia hyperplasia; and carcinoma in situ. Among the epithelial dysplasias, atypical hyperplasia is the intermediate between benign and malignant change, and is the key point from quantitative to qualitative change, including abnormal tissue structure and cytologic abnormality. Atypical hyperplasia is divided into three levels: mild; moderate; and severe. Mild atypical hyperplasia is characterized by a small number of atypical cells, small cellular atypia, and the tissue structure is disordered and confined to one-third of the epithelial layer. The tissue structure disorder does not exceed two-thirds of the epithelial cell in moderate atypical hyperplasia. Severe atypical hyperplasia is characterized by a change in cellular atypia and the tissue structure disorder is greater than two-thirds of the epithelial cell. The malignant transformation rate of precancerous lesions increases with the severity of dysplasia [2].
A menopause survey of women with benign breast disease history in northwest China
Published in Climacteric, 2019
W.J. Gou, J.Z. Zhao, R. Zhang, T. Yang, L.Y. Wang, X.H. Zhang
Based on the degree of cellular proliferation and atypia, benign breast lesions can histologically fall into three types: non-proliferative, proliferative without atypia, and atypical hyperplasia. The proliferative without atypia and atypical hyperplasia types may increase the patient’s future risk of developing breast cancer, whereas no increased risk was found in women with no family history and non-proliferative findings5–7. Most lesions that occur in the breast are benign. The non-proliferative breast lesion is the most common category and most women suffering benign disease are not at increased risk of cancer6,7. However, many studies have been made on women who have MPS with a breast cancer history, yet those with a history of benign breast disease have been rarely reported in a menopause survey.
Thickened endometrium in asymptomatic postmenopausal women – determining an optimum threshold for prediction of atypical hyperplasia and cancer
Published in Journal of Obstetrics and Gynaecology, 2018
Ahmed Ghoubara, Emmanuel Emovon, Sudha Sundar, Ayman Ewies
All postmenopausal women with incidental finding of ET >4 mm without PMB were offered a Pipelle endometrial biopsy. However, the decision to perform a hysteroscopy was individualised after the discussion between the patient and consultant. The women were categorised according to the investigation results into: (i) Group 1: benign endometrium (including benign endometrial polyps) and (ii) Group 2: endometrial atypical hyperplasia and cancer. Endometrial atypical hyperplasia and cancer were combined as a single disease. This is because of the high rate of undercall and a progression to cancer when an atypical hyperplasia is found (Gallos et al. 2013; Smith et al. 2014).