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Le lesioni colonnari Anna Sapino Università di Torino

Le lesioni colonnari Anna Sapino Università di Torino. Columnar Alteration With Prominent Apical Snouts and Secretions: A Spectrum of Changes Frequently Present in Breast Biopsies Performed for Microcalcifications. Am J Surg Pathol. 1998 Dec;22(12):1521-7.

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Le lesioni colonnari Anna Sapino Università di Torino

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  1. Le lesioni colonnari Anna Sapino Università di Torino

  2. Columnar Alteration With Prominent Apical Snouts and Secretions: A Spectrum of Changes Frequently Present in Breast Biopsies Performed for Microcalcifications Am J Surg Pathol. 1998 Dec;22(12):1521-7. Fraser JL, Raza S, Chorny K, Connolly JL, Schnitt SJ.

  3. Columnar alteration of lobules. This lesion is characterized by an enlarged lobule with slightly dilated acini (A). The acini are lined by a single layer of columnar epithelial cells with elongated nuclei (B). Apical snout Am J Surg Pathol. 1998 Dec;22(12):1521-7.

  4. Am J Surg Pathol. 1998 Dec;22(12):1521-7. Lobules are composed of slightly dilated acini (A). The epithelial cells have enlarged, ovoid to round nuclei and vesicular chromatin, with variably prominent nucleoli. In some lesions, these atypical cells are present in a single layer (B). In others, there is epithelial cell stratification and tufting (C). Although the lesions illustrated in (B) and (C) show cytologic atypia, they do not have architectural features diagnostic of atypical ductal hyperplasia or ductal carcinoma in situ. (D) A lesion with similar cytologic features but in which arcades and bridges are also prominent. Given the architectural pattern, such lesions are probably best designated atypical ductal hyperplasia. 8 lavori successivi

  5. Columnar Cell Lesions of the Breast SJ. Schnitt, A Vincent-Salomon Advances in Anatomic Pathology 10: 113–124 (2003) Columnar cell change Columnar cell hyperplasia Advances in Anatomic Pathology Vol. 10, No. 3, pp. 113–124

  6. Columnar cell change with atypia Advances in Anatomic Pathology Vol. 10, No. 3, pp. 113–124 (2003) Columnar cell hyperplasia with atypia

  7. CCC Category 1 CCC with cytological atypia Category 6 CCH Category 2 CCH with architectural atypia Category 3 CCH with cytological atypia Category 4 CCH with cytological atypia + architectural atypia Category 5 Am J Surg Pathol 2005;29:734–746

  8. WHO 2003

  9. Modern Pathology (2006) 19, 172–179 Interobserver reproducibility in the diagnosis of flat epithelial atypia of the breast Frances P O’Malley, Syed K Mohsin, Sunil Badve, Shikha Bose, Laura C Collins, Marguerite Ennis, Celina G Kleer, Sarah E Pinder and Stuart J Schnitt CCC CCH CCC with atypia FEA CCH with atypia

  10. CCC OVERALL AGREEMENT (92.8%) CCH

  11. OVERALL AGREEMENT (90.4%) FEA

  12. Columnar cell hyperplasia is associated with lobular carcinoma in situ and tubular carcinoma Rosen PP Am J Surg Pathol. 1999 Dec;23(12):1561 High Frequency of Coexistence of Columnar Cell Lesions, Lobular Neoplasia, and Low Grade Ductal Carcinoma In Situ With Invasive Tubular Carcinoma and Invasive Lobular Carcinoma Am J Surg Pathol 2007;31:417–426 The ‘‘Rosen Triad’’: Tubular Carcinoma, Lobular Carcinoma In Situ, and Columnar Cell Lesions Adv Anat Pathol. 2008 May;15(3):140-6.

  13. Columnar Cell Lesions of the Breast: The Missing Link in Breast Cancer Progression? A Morphological and Molecular Analysis Am J Surg Pathol 2005;29:734–746 CCLs consistently harbor recurrent chromosomal abnormalities and should be seen as clonal and neoplastic rather than hyperplastic proliferations

  14. J Pathol 2005; 205: 248–254 Low grade arm

  15. Am J Surg Pathol 2007;31:417–426

  16. The ‘‘Rosen Triad’’: Tubular Carcinoma, Lobular Carcinoma In Situ, and Columnar Cell Lesions Suzanne M. Brandt, MD, Gloria Q. Young, MD, and Syed A. Hoda, MD Adv Anat Pathol. 2008 May;15(3):140-6.

  17. Lesioni a cellule colonnari senza atipie Lesioni a rischio evolutivo? Escissione sempre?

  18. Bonser, Dossett and Jull. 1961 Columnar metaplasia • Azzopardi 1979. Blunt duct adenosis • BDA with response of the specific stroma (organoid) • Non-organoid BDA • Microcystic BDA

  19. Lesioni a cellule colonnari senza atipie Lesioni a rischio evolutivo? NO Escissione sempre? NO

  20. Tibor Tot • Aberration of the Normal Development and Involution (ANDI): • clear cell changes • lactational changes • apocrine metaplasia • fibroadenomtoid changes • sclerosing adenosis • microcystic changes/blunt duct adenosis • etc

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