PRAKTIKUM BLOK REPRODUKSI

( BREAST )
Dr. Duti S. Aziz, SpPA
DEPARTEMEN PA FK UHT
FIBROCYSTIC CHANGE
 MACROSCOPIS
• Lump
• Ill-defined
• Diffusely increased density and discrete nodularities.
• Fibrosis
• Cyst :
– A single large cyst may form within one breast, but the
disorder is usually multifocal and often bilateral.
– Multiple
– cluster
• 1 cm - 5 cm in diameter.
• Unopened, they are brown to blue (blue
dome cysts) , filled with serous, turbid fluid.
• The secretory products within the cysts may
calcify to appear as microcalcifications in
mammograms
MACROSCOPIS
MACROSCOPIS
 MICROSCOPIS
• Small cyst → The epithelium is cuboidal to
columnar and is sometimes multilayered in
focal areas.
• Large cyst → flattened / totally atrophic
• Occasionally, mild epithelial proliferation leads
to piled-up masses or small papillary
excrescences.
• Frequently, cysts are lined by large polygonal
cells that have an abundant granular,
eosinophilic cytoplasm, with small, round,
deeply chromatic nuclei, called apocrine
metaplasia
• The stroma surrounding all forms of cysts is
usually compressed fibrous tissue, having lost
its normal delicate, myxomatous appearance.
MICROSCOPIS
Figure 23-8 A, A normal duct or acinus with a single basally located myoepithelial cell layer (cells
with dark, compact nuclei and scant cytoplasm) and a single luminal cell layer (cells with larger
open nuclei, small nucleoli, and more abundant cytoplasm). B, Epithelial hyperplasia. The lumen
is filled by a heterogeneous, mixed population of luminal and myoepithelial cell types. Irregular
slitlike fenestrations are prominent at the periphery.
Downloaded from: StudentConsult (on 22 March 2011 11:50 PM)
© 2005 Elsevier
Fibroadenoma
 Clinical Features
• The most common benign tumor of the
female breast.
• Age: reproductive period.
• Frequently multiple & bilateral.
• Symptoms:
– Well define palpable mass
– painless and
– mobile.
 Macroscopic
• Spherical nodule
• Solid
• Firm and rubbery
• Well demarcated --- pseudocapsule
• Gray white
FIBROADENOMA MAMMA
 Microscopic
• The tumor consisted of proliferation of ductuli
and proliferation of fibromixomatic stroma.
– Proliferation of ductuli may form a slit-like
spaces (called intracanalicular)
– Or may form round spaces (called
pericanalicular)
– The fibromixomatic stroma contain spindle
cells and stellate cells.
INVASIF DUCTAL CARCINOMA
 CLINICAL FEATURES
• Palpable mass, padat
• Batas jelas
• Irregular
• Nyeri + / -
• Peau d’orange
• Retraksi kulit
• Retraksi nipple
 MACROSCOPIS
• Nodul putih abu – abu
• Batas jelas, tepi irregular, spiculated
• Padat kenyal
• Bercak – bercak kekuningan ( yellow chalky
streak )
 MICROSCOPIS
• Proliferasi sel anaplasi epithel ductuli
• Low grade – high grade
• Angio invasi
• Lymph – invasi
• Perineural invasi
PHYLLODES TUMOR
• Stroma
• Dekade 6
• = cystosarcoma phyllodes
• Tumbuh cepat
• Benign, borderline, malignant
• >> benign
• Lokal recurrent
• 1/3 kasus → Metastase ( komponen stroma ) →
>> paru
 Maroscopis
• Tumor mulai Ø 5 cm s/d 20 cm
• Kenyal
• Batas jelas
• Abu-abu keputihan
• Irisan mengandung lendir, kista dan lipatan-
lipatan
• Bulbous protrusion

•
• Proliferasi stroma dilapisi epithel ~ leaf like →
cystic
• High grade → Bisa terdapat fokus
rhabdomyosarcoma, liposarcoma
• Malignant : mitosis >>, tepi infiltratif
Figure 23-30 Phyllodes tumor. Compared to a fibroadenoma, there is increased stromal cellularity, cytologic atypia, and stromal overgrowth, giving rise to the typical leaflike
Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 12 June 2006 06:48 AM)
42
architecture.
© 2005 Elsevier
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