Path Image
Increased proliferation of ductules and stroma
IMAGE DESCRIPTIONS

The lesion consists of enlarged mammary lobules with an increased epithelial to stromal ratio, manifest by an increased proliferation of ductules. There is both interlobular stromal fibrosis as well as more prominent intralobular fibrosis (the normal slightly blue myxoid stroma within lobules is completely lost and instead hyalinized).

The cytology is bland and all the ductules are surrounded by myoepithelium.

The duct lumens are open and patent, resembling the pericanalicular pattern of fibroadenomas

Here we see a trichrome stain which highlights the extensive stromal fibrosis

BACKGROUND

First described in the mid 1980's, sclerosing lobular hyperplasia (SLH) describes a benign sclerosing lesion of young women closely related (and possibly a precursor) to fibroadenoma, characterized by extensive lobular hyperplasia with both intra and interlobular stromal fibrosis.

Fibroadenomas may arise from SLH via a localized and accelerated proliferation/overgrowth of ductal epithelium, and many use the term fibroadenomatoid mastopathy synonymously with SLH.

CLINICAL

Present similarly to fibroadenoma, and most of the time the preoperative diagnosis is either fibroadenoma or fibrocystic changes. Usually seen either in adolescent or young women (mean age 28-32yrs).

TREATMENT

Complete excision is curative.

PROGNOSIS

Completely benign, although recurrence as a fibroadenoma rarely occurs.

PEARLS

- Can resemble "miniature" fibroadenomas

REFERENCES

Rosen PP. Rosen's Breast Pathology. 2nd Ed. Philadelphia: Lippincott Williams & Wilkins; 2001:8, 163.

Kovi J et al. Sclerosing lobular hyperplasia manifesting as a palpable mass of the breast in young black women. Human Pathology (1984)15:4;336-40.

Last updated: 2012-02-05
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