Intraductal papilloma of breast

Case contributed by Bruno Di Muzio

Presentation

Nipple discharge on the left.

Patient Data

Age: 60 years
Gender: Female

Mammography

mammography

A surgical clip is noted in the medial right breast, with adjacent scarring. Moderately dense fibroglandular tissue. Scattered calcification is stable. No suspicious lesion, microcalcification or stromal distortion.

Ultrasound

ultrasound

The left nipple is retracted. Within the left breast, just medial to the nipple (9 o'clock) is a dilated duct containing an isoechoic lesion measuring 11mm in maximal dimensions demonstrating internal vascularity. It was non-compressible. No further lesions were identified within the vicinity of the nipple. This lesion was subsequently biopsied. No abnormal axillary lymph nodes.

Case Discussion

MICROSCOPIC DESCRIPTION: The sections show multiple cores of breast parenchyma which contains a papillary lesion. The papillary lesion is lined by a dual layer of epithelium. There is no evidence of in-situ or invasive malignancy.

DIAGNOSIS: Papillary lesion. Features in keeping with a papilloma.

As in this case, mammograms are frequently normal for intraductal papillomas, particularly the small ones. 

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