Elucidating encounters of atypical ductal hyperplasia arising in gynaecomastia. Issue 3 (25th November 2014)

• Record Type: Journal Article
• Authors: Wells, Justin M; Liu, Yifang; Ginter, Paula S; Nguyen, Michaela T; Shin, Sandra J
• Is Part Of: Histopathology. Volume 66:Issue 3(2015)
• Page Start: 398
• Page End: 408
• Publication Date: 2014-11-25
• Subjects: Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12545
• Languages: English
• ISSNs: 0309-0167

Abstract

<abstract abstract-type="main" id="his12545-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="his12545-sec-0001" sec-type="section"> <title>Aims</title> <p>Atypical ductal hyperplasia (ADH) rarely arises in gynaecomastia. We set out to understand more clearly the clinical, histological and immunohistochemical features of ADH in this setting.</p> </sec> <sec id="his12545-sec-0002" sec-type="section"> <title>Methods and results</title> <p>Twenty‐five cases of ADH arising in gynaecomastia, nine cases of ductal carcinoma <italic>in situ</italic> (DCIS) and 36 cases of gynaecomastia with usual ductal hyperplasia (UDH) were studied. Reviews of clinical, morphological and immunohistochemical findings were performed. The extent of cytokeratin 5/6 (CK5/6) luminal epithelial cell staining was assessed (0% = 0, <10% = 1, 10–50% = 2 and >50% = 3). Oestrogen receptor (ER) was evaluated using the H‐scoring system. The average age of ADH patients was 35 years (range 14–78). ADH was bilateral in 20% and less frequent in active gynaecomastia (24%). ADH often showed a cribriform pattern (72%), with less nuclear variation/size and similar frequency of mitoses than UDH cells. CK5/6 luminal epithelial staining was decreased in ADH (68%) versus UDH (11%). ADH showed high ER expression compared to UDH (H score >270 in 88% and 14%, respectively).</p> </sec> <sec id="his12545-sec-0003" sec-type="section"> <title>Conclusions</title> <p>ADH in gynaecomastia can be distinguished from UDH by morphological and immunhistochemical features. We also identified a subset of young patients (<25 years) with extensive bilateral ADH. More studies are needed to characterize this patient subset more clearly.</p> </sec> </abstract>