COMSAE 110/ 152 Completely Solved
Questions/ A+ Score Solution.
Fibroadenoma - Answer: F <35
Small, mobile mass
Made of fibrous tissue & glands
Inc size & tenderness w/ estrogen
Intraductal papilloma - Answer: Fibroepithelial tumor in lactiferous ducts
Usually beneath areola
Most common cause of nipple discharge (bloody or serous)
Phyllodes tumor - Answer: Large mass of CT w/ "leaflike" lobulated cysts
5th decade
May become malignant
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,Breast cancer is often due to overexpression of - Answer: estrogen/progesterone
receptors or HER2
-triple negative (ER, PR, & HER2 neg = more aggressive)
Give 3 noninvasive breast carcinomas - Answer: Ductal carcinoma in situ
Paget disease
Lobular carcinoma in situ
Ductal carcinoma in situ:
gross morphology (2)
micro morphology (2)
penetrates the basement mem?
subtype (1) - Answer: Gross: fills duct lumen & engorged blood vessels
Micro: ductal atypia & microcalcifications on mammography
Does NOT penetrate basement membrane
Subtype = comedocarcinoma
Comedocarcinoma - Answer: DCIS w/ central necrosis & dystrophic calcification
Paget disease - Answer: Extension of DCIS up lactiferous ducts & into skin of
nipple
-eczematous patches over nipple & areola
-Paget cells = intraepithelial adenocarcinoma cells (large cells surrounded by clear
halo)
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,Lobular carcinoma in situ:
genetics
mass & calcifications?
risk of cancer? - Answer: Genetics: dec E-cadherin
No mass or calcifications (Incidental finding on biopsy)
Inc risk of cancer
Give 4 invasive breast carcinomas - Answer: invasive ductal
Invasive lobular
Medullary
Inflammatory
Invasive ductal carcinoma:
gross morphology
micro morphology - Answer: Most common invasive breast cancer
Gross: firm, fibrous "rock hard" mass
Micro: glandular, ductlike cells in desmoplastic stroma
Invasive lobular carcinoma:
genetics
micro morphology
BL or UL - Answer: Genetics: dec E-cadherin
Micro: orderly row of cells, NO duct formation, lacks desmoplastic response
BL
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, *lines of cells = lobular
Medullary carcinoma:
micro morphology - Answer: Micro: large, anaplastic cells in sheets w/
lymphocytes & plasma cells
-well-circumscribed, can mimic fibroadenoma
Inflammatory carcinoma of the breast - Answer: Dermal lymph invasion = breast
pain, warmth, swelling, erythematous skin around hair follicles (peau d'orange)
Poor prognosis
Often mistaken for Paget or mastitis
Lacks a palpable mass
Testicular varicocele - Answer: Dilated pampiniform plexus veins
Most common cause of scrotal enlargement in adults
L side
"bag of worms"
Does NOT transilluminate
Congenital hydrocele - Answer: Common cause of scrotal swelling in infants
Incomplete obliteration of processus vaginalis
Spontaneously resolve
Transilluminate
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Questions/ A+ Score Solution.
Fibroadenoma - Answer: F <35
Small, mobile mass
Made of fibrous tissue & glands
Inc size & tenderness w/ estrogen
Intraductal papilloma - Answer: Fibroepithelial tumor in lactiferous ducts
Usually beneath areola
Most common cause of nipple discharge (bloody or serous)
Phyllodes tumor - Answer: Large mass of CT w/ "leaflike" lobulated cysts
5th decade
May become malignant
Page 1 of 33
,Breast cancer is often due to overexpression of - Answer: estrogen/progesterone
receptors or HER2
-triple negative (ER, PR, & HER2 neg = more aggressive)
Give 3 noninvasive breast carcinomas - Answer: Ductal carcinoma in situ
Paget disease
Lobular carcinoma in situ
Ductal carcinoma in situ:
gross morphology (2)
micro morphology (2)
penetrates the basement mem?
subtype (1) - Answer: Gross: fills duct lumen & engorged blood vessels
Micro: ductal atypia & microcalcifications on mammography
Does NOT penetrate basement membrane
Subtype = comedocarcinoma
Comedocarcinoma - Answer: DCIS w/ central necrosis & dystrophic calcification
Paget disease - Answer: Extension of DCIS up lactiferous ducts & into skin of
nipple
-eczematous patches over nipple & areola
-Paget cells = intraepithelial adenocarcinoma cells (large cells surrounded by clear
halo)
Page 2 of 33
,Lobular carcinoma in situ:
genetics
mass & calcifications?
risk of cancer? - Answer: Genetics: dec E-cadherin
No mass or calcifications (Incidental finding on biopsy)
Inc risk of cancer
Give 4 invasive breast carcinomas - Answer: invasive ductal
Invasive lobular
Medullary
Inflammatory
Invasive ductal carcinoma:
gross morphology
micro morphology - Answer: Most common invasive breast cancer
Gross: firm, fibrous "rock hard" mass
Micro: glandular, ductlike cells in desmoplastic stroma
Invasive lobular carcinoma:
genetics
micro morphology
BL or UL - Answer: Genetics: dec E-cadherin
Micro: orderly row of cells, NO duct formation, lacks desmoplastic response
BL
Page 3 of 33
, *lines of cells = lobular
Medullary carcinoma:
micro morphology - Answer: Micro: large, anaplastic cells in sheets w/
lymphocytes & plasma cells
-well-circumscribed, can mimic fibroadenoma
Inflammatory carcinoma of the breast - Answer: Dermal lymph invasion = breast
pain, warmth, swelling, erythematous skin around hair follicles (peau d'orange)
Poor prognosis
Often mistaken for Paget or mastitis
Lacks a palpable mass
Testicular varicocele - Answer: Dilated pampiniform plexus veins
Most common cause of scrotal enlargement in adults
L side
"bag of worms"
Does NOT transilluminate
Congenital hydrocele - Answer: Common cause of scrotal swelling in infants
Incomplete obliteration of processus vaginalis
Spontaneously resolve
Transilluminate
Page 4 of 33
