What´s Ductal Hyperplasia?
Ductal hyperplasia
Ductal hyperplasia is characterized by proliferation of ductal epithelium, resulting in increased cellularity and multi layering of ductal epithelium. The pattern of growth varies greatly from case to case leading to different types of ductal hyperplasia.
Features indicative of benign nature of the lesion includes oval nuclei with indistinct cytoplasmic border and eosinophilic rather than pale cytoplasm, arrangement of the cells in parallel bundles, presence of peripheral elongated clefts in ducts, presence of myoepithelial layer, apocrine metaplasia and absence of necrosis.
Ductal hyperplasia has been subdivided into mild, moderate and florid categories. In mild ductal hyperplasia, the epithelial thickness is
3 to 4 cell layer. In moderate hyperplasia, the thickness of epithelium is more than 4 layers and in florid hyperplasia, the gland lumen is often obliterated by proliferative epithelium and the affected duct is enlarged.
Atypical ductal hyperplasia shares some features with intraductal carcinoma. The cells are monomorphic with round nuclei and distinct cytoplasmic border. Cytologic atypia is defined by high nuclear to cytoplasm ratio, hyperchromasia of nuclei and enlarged nucleoli. Mitotic activity is more seen in atypical ductal hyperplasia.
Lobular hyperplasia
Lobular hyperplasia is a lesion in which lobules are larger and more cellular. The lobular hyperplasia may occur in the setting of hormonal stimulation as in pregnancy.
Atypical lobular hyperplasia characterized by proliferation of abnormal cells similar to the cell of lobular carcinoma in situ in one or more lobules. Atypical lobular hyperplasia increases the risk of cancer development.
The management of women with AEH is not consensual because of uncertainty about their diagnosis related to the type of the biopsy sampling and their controversial clinical signification between risk marker and true precursor of breast cancer.
Ductal hyperplasia is characterized by proliferation of ductal epithelium, resulting in increased cellularity and multi layering of ductal epithelium. The pattern of growth varies greatly from case to case leading to different types of ductal hyperplasia.
Features indicative of benign nature of the lesion includes oval nuclei with indistinct cytoplasmic border and eosinophilic rather than pale cytoplasm, arrangement of the cells in parallel bundles, presence of peripheral elongated clefts in ducts, presence of myoepithelial layer, apocrine metaplasia and absence of necrosis.
Ductal hyperplasia has been subdivided into mild, moderate and florid categories. In mild ductal hyperplasia, the epithelial thickness is
3 to 4 cell layer. In moderate hyperplasia, the thickness of epithelium is more than 4 layers and in florid hyperplasia, the gland lumen is often obliterated by proliferative epithelium and the affected duct is enlarged.
Atypical ductal hyperplasia shares some features with intraductal carcinoma. The cells are monomorphic with round nuclei and distinct cytoplasmic border. Cytologic atypia is defined by high nuclear to cytoplasm ratio, hyperchromasia of nuclei and enlarged nucleoli. Mitotic activity is more seen in atypical ductal hyperplasia.
Lobular hyperplasia
Lobular hyperplasia is a lesion in which lobules are larger and more cellular. The lobular hyperplasia may occur in the setting of hormonal stimulation as in pregnancy.
Atypical lobular hyperplasia characterized by proliferation of abnormal cells similar to the cell of lobular carcinoma in situ in one or more lobules. Atypical lobular hyperplasia increases the risk of cancer development.
The management of women with AEH is not consensual because of uncertainty about their diagnosis related to the type of the biopsy sampling and their controversial clinical signification between risk marker and true precursor of breast cancer.