Abstract:
CONTEXT:More than 25 years ago, John G. Azzopardi described a distinctive intraepithelial neoplastic breast lesion, which he designated "clinging carcinoma in situ"; he considered it as another variant of ductal carcinoma in situ, an early lesion that can easily be missed because the changes are mainly cytologic rather than architectural. The lesion remained widely unrecognized and/or ignored until recent years when its neoplastic nature was confirmed at the molecular-genetic level. OBJECTIVE:To deal with historical aspects of the evolving concept of "clinging" and to focus on several important issues such as characteristic morphologic features with particular attention to the diagnostic criteria and differential diagnoses, recent molecular-genetic findings, appropriate terminology and classification, as well as the significance of this type of lesion for both surgical pathologists and clinicians. DATA SOURCES:A thorough search of the literature was performed and publications using a variety of designations including "clinging carcinoma in situ," "flat epithelial atypia," "ductal intraepithelial neoplasia-flat type," "atypical cystic lobules," "columnar cell change with atypia," "columnar cell hyperplasia with or without atypia," "columnar alteration with prominent apical snouts and secretion," and so forth were reviewed. CONCLUSIONS:This distinctive lesion represents one of the earliest morphologically recognizable neoplastic alterations of the breast that is commonly associated with mammographically suspicious microcalcifications. It is characterized by mildly to severely atypical cells simply replacing the single layer of native epithelial cells in a flat fashion without appreciable proliferation; tufting, intraluminal bridging, micropapillary structures, and so forth are typically absent or very focal and minimal, if present at all. Based on the degree of cytologic atypia, low- and high-grade flat ductal intraepithelial neoplasia need to be separated. Although additional studies are needed to better understand the clinical significance of flat ductal intraepithelial neoplasia, several lines of evidence strongly support the concept of clinging. Indeed, as pointed out by Azzopardi, surgical pathologists need to pay more attention to the cytologic alterations of the breast lesions by analyzing the involved cell populations using high-power magnification.
journal_name
Arch Pathol Lab Medjournal_title
Archives of pathology & laboratory medicineauthors
Moinfar Fdoi
10.1043/1543-2165-133.6.879subject
Has Abstractpub_date
2009-06-01 00:00:00pages
879-92issue
6eissn
0003-9985issn
1543-2165pii
2008-0482-RAR1journal_volume
133pub_type
杂志文章,评审abstract::Myocardial lesions were seen in dogs subjected to experimental hemorrhagic shock. In contrast, dogs that had been previously surgically treated by cardiac denervation and adrenalectomy, showed less myocardial damage. The latter group also had a substantially decreased myocardial I-norepinephrine content and a much low...
journal_title:Archives of pathology & laboratory medicine
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract::This project was designed to evaluate different criteria used in the interpretation of the human immunodeficiency virus type 1 (HIV-1) Western blot assay on a group of serum samples blinded to the examiner that were collected from individuals attending three different public health departments in central North Carolin...
journal_title:Archives of pathology & laboratory medicine
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abstract::The association of cancer and death in laypeoples' thinking has resulted in discussions of cancer diagnoses often being held sub rosa. Open acceptance of a diagnosis of cancer cannot only help to dispel associated fears but also can serve to educate other persons to recognize that cancers can be cured. Open discussion...
journal_title:Archives of pathology & laboratory medicine
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abstract::Myocyte injury in acute cardiac transplant rejection was studied ultrastructurally in 45 patients. Mild myocyte injury consisted of increased glycogen granules and mitochondria, and condensation and streaming of myofilaments. More severe cell injury was characterized by clumping of Z-band material at the periphery of ...
journal_title:Archives of pathology & laboratory medicine
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abstract::Reported is an instance of bronchiolitis obliterans due to the accumulation of lipid-laden cells within bronchiolar walls and lumina. The bronchiolar lining had extensive squamous and goblet cell metaplasia with focal ulceration. Scattered foci of cholesterol pneumonia, composed of acicular crystals with an associated...
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abstract:BACKGROUND:Metanephric adenoma is a very rare benign renal tumor; only 80 well-documented cases have been reported to date. We have seen several renal tumors that were originally incorrectly diagnosed as metanephric adenoma. DESIGN:We present 3 unusual renal tumors (2 primary and 1 metastatic), each of which illustrat...
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journal_title:Archives of pathology & laboratory medicine
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更新日期:1984-09-01 00:00:00
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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journal_title:Archives of pathology & laboratory medicine
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