EURORAD ESR

Case 15724

Intracystic papilloma. A case report

Author(s)
Vidal González, Ana; Montes Fernández, Myriam; Ciudad Fernández, María José; Lannegrand Menéndez, Beatriz; García Diego, Guillermo J.

HOSPITAL CLÍNICO SAN CARLOS; C/ del Profesor Martín Lagos, s/n, 28040, MADRID, Spain; Email:ana.vidalglez91@gmail.com
 
Patient
female, 56 year(s)
 
 
  • Figure 1
    Mammography

    Mammography reveals multiple well-defined oval shaped masses with high attenuation compared with the surrounding tissue. It also shows a 3 cm oval nodule with lobulated margins located in the inner central quadrant of...

     
    Area of Interest: Breast; Imaging Technique: Mammography; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Ultrasonography
     

    Ultrasonography shows a large well-circumscribed complex cystic lesion with lobulated margins. It presents an hypoechogenic solid component with an anechoic cystic pole. Doppler study reveals marked internal...

     
    Area of Interest: Breast; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    Ultrasound-guided core biopsy of the solid component.

     
    Area of Interest: Breast; Imaging Technique: Ultrasound; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 3
    MRI
     

    Solid component shows low signal on T2-weighted images, while the cystic component is hyperintense.

     
    Area of Interest: Breast; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    The solid component shows heterogeneous enhancement on sequences after gadolinium.

     
    Area of Interest: Breast; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    The lesion shows a fast and early enhancement with plateau enhancement pattern in dynamic study.

     
    Area of Interest: Breast; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    The kinetic analysis reveals a type 2 curve, with rapid initial rise followed by a plateau in the delayed phase.

     
    Area of Interest: Breast; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    Pathologic examination
     

    Hematoxylin-eosin stain reveals proliferation of ductal epithelium supported by frond-forming fibrovascular stroma.

     
    Area of Interest: Breast; Imaging Technique: PACS; Procedure: Biopsy; Special Focus: Pathology;

    High-power field shows a bening papillary outgrowth with branching fronds of stroma and overlying epithelial and myoepithelial cells. No cytologic atypia or abnormal mitoses are shown.

     
    Area of Interest: Breast; Imaging Technique: PACS; Procedure: Biopsy; Special Focus: Pathology;
     
     
Mammography reveals multiple well-defined oval shaped masses with high attenuation compared with the surrounding tissue. It also shows a 3 cm oval nodule with lobulated margins located in the inner central quadrant of the left breast.
 
Ultrasonography shows a large well-circumscribed complex cystic lesion with lobulated margins. It presents an hypoechogenic solid component with an anechoic cystic pole. Doppler study reveals marked internal vascularity in the solid component.
 
Ultrasound-guided core biopsy of the solid component.
 
Solid component shows low signal on T2-weighted images, while the cystic component is hyperintense.
 
The solid component shows heterogeneous enhancement on sequences after gadolinium.
 
The lesion shows a fast and early enhancement with plateau enhancement pattern in dynamic study.
 
The kinetic analysis reveals a type 2 curve, with rapid initial rise followed by a plateau in the delayed phase.
 
Hematoxylin-eosin stain reveals proliferation of ductal epithelium supported by frond-forming fibrovascular stroma.
 
High-power field shows a bening papillary outgrowth with branching fronds of stroma and overlying epithelial and myoepithelial cells. No cytologic atypia or abnormal mitoses are shown.
 
 
 
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