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Medullary carcinoma

Medullary carcinoma. Medullary carcinoma. Mucinous “colloid” carcinoma. Rare, occurs in older ages. * Grossly: Slowly growing, large, soft, gelatinous mass. * Microscopically: Lakes of mucin with scattered small islands of malignant cells. Mucinous carcinoma. Mucinous carcinoma.

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Medullary carcinoma

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  1. Medullary carcinoma Cancer breast

  2. Medullary carcinoma Cancer breast

  3. Mucinous “colloid” carcinoma • Rare, occurs in older ages. * Grossly:Slowly growing, large, soft, gelatinous mass. * Microscopically:Lakes of mucin with scattered small islands of malignant cells. Cancer breast

  4. Mucinous carcinoma Cancer breast

  5. Mucinous carcinoma Cancer breast

  6. Paget disease of the breast * Def.:infiltrating duct carcinoma which invades the epidermis of the nipple and areola. * Grossly: The skin of the nipple and areola is red, moist, scaly and ulcerating resembling eczema with an underlying breast mass * Microscopically: • The epidermis is infiltrated by large, mucopolysaccharide-filled tumor cells which are most prominent in the basal portion of the epidermis. Cancer breast

  7. Paget’s disease Cancer breast

  8. Lobular carcinoma Cancer breast

  9. Carcinomas of mammary lobulesI. lobular carcinoma in situ (LCIS) • The pre-invasive stage of infiltrating lobular carcinoma. • Less common than duct carcinoma in situ. * Grossly: • Usually No mass, and discovered incidentally. • The lesions are often bilateral. * Microscopically: • One or more breast lobules are involved. • The terminal ductules and acini are distended with small rounded malignant cells. Cancer breast

  10. Cancer breast

  11. II. Infiltrating lobular carcinoma * Grossly: • Ill-defined, rubbery or hard mass. • The tumor is usually multicentric and bilateral. * Microscopically: • Malignant epithelial cells arranged in strands of one cell width giving Indian file pattern separated by fibrous tissue stroma invading the perilobular connective tissue in a concentric manner around the lobules and terminal ducts with LCIS (targetoid pattern). • The cells are small, rounded and uniform with little pleomorphism. Cancer breast

  12. Cancer breast

  13. * Spread of breast carcinoma: 1. Direct spread to: • Pectoral muscle and fascia, chest wall and pleura. • Overlying skin causing ulceration, nipple retraction and pea d’orange. Cancer breast

  14. 2. Lymphatic spread: by two ways: a. Lymphatic embolization:leads to metastasis in the draining lymph nodes (axillary, internal mammary, mediastinal & supraclavicular) – opposite breast, liver & peritoneum. b.Lymphatic permeation: means obstruction of the skin lymphatic by the tumor cells leading to skin manifestations of cancer breast………… 3. Blood spread: occurs early or late, to lung, liver, bone or brain.. Cancer breast

  15. causes of breast lump (mass) • Traumatic: a. Hematoma b. traumatic fat necrosis. 2. Inflammatory: Breast abscess, traumatic fat necrosis, plasma cell mastitis, T.B, syphilis and actinomycosis. 3. Hyperplastic mass (fibrocystic diseases of the breast). 4. Neoplastic mass:benign or malignant. Cancer breast

  16. Thanks References:Robbins and Cotran’s: Pathologic Basis of Disease. Seventh edition. Cancer breast

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