Fibroadenoma pathophysiology: Difference between revisions
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==Pathogenesis== | ==Pathogenesis== | ||
* Fibroadenoma is a common [[benign]] [[tumor]] of the [[breast]]. | * Fibroadenoma is a common [[benign]] [[tumor]] of the [[breast]]. | ||
* Fibroadenoma is a proliferation of stromal and epithelial cells originating from the terminal duct lobular unit.<ref name="pmid24872735">{{cite journal |vauthors=Cerrato F, Labow BI |title=Diagnosis and management of fibroadenomas in the adolescent breast |journal=Semin Plast Surg |volume=27 |issue=1 |pages=23–5 |date=February 2013 |pmid=24872735 |pmc=3706050 |doi=10.1055/s-0033-1343992 |url=}}</ref> | |||
* Fibroadenoma arises from [[connective tissue]] [[cell]]s, which are cells that are normally involved in the functional and mechanical support of the surrounding tissues. | * Fibroadenoma arises from [[connective tissue]] [[cell]]s, which are cells that are normally involved in the functional and mechanical support of the surrounding tissues. | ||
* The majority of fibroadenomas are benign and do not demonstrate any [[malignant]] potential. | * The majority of fibroadenomas are benign and do not demonstrate any [[malignant]] potential. | ||
* Fibroadenoma demonstrate estrogen and progesterone sensitivity and may grow during pregnancy.<ref name="wiki">Fibroadenoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Fibroadenoma Accessed on January, 29 2016</ref><ref name="patho">Fibroadenoma. Libre Pathology (2015) http://librepathology.org/wiki/index.php/Fibroadenoma Accessed on January, 29 2016</ref><ref name="patho2">Breast-nonmalignant-Fibroadenoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/breastfibroadenoma.html Accessed on January, 29 2016</ref><ref name="radio">Fibroadenoma. Radiopaedia (2015) http://radiopaedia.org/articles/fibroadenoma-of-the-breast-1 Accessed on January, 29 2016</ref> | * Fibroadenoma demonstrate estrogen and progesterone sensitivity and may grow during pregnancy.<ref name="wiki">Fibroadenoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Fibroadenoma Accessed on January, 29 2016</ref><ref name="patho">Fibroadenoma. Libre Pathology (2015) http://librepathology.org/wiki/index.php/Fibroadenoma Accessed on January, 29 2016</ref><ref name="patho2">Breast-nonmalignant-Fibroadenoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/breastfibroadenoma.html Accessed on January, 29 2016</ref><ref name="radio">Fibroadenoma. Radiopaedia (2015) http://radiopaedia.org/articles/fibroadenoma-of-the-breast-1 Accessed on January, 29 2016</ref> | ||
* It is thought that the [[hormone]]-[[receptor]] mechanism mediates the excessive proliferation of epithelial and stromal cells.<ref name="pmid16554735">{{cite journal| author=Sapino A, Bosco M, Cassoni P, Castellano I, Arisio R, Cserni G et al.| title=Estrogen receptor-beta is expressed in stromal cells of fibroadenoma and phyllodes tumors of the breast. | journal=Mod Pathol | year= 2006 | volume= 19 | issue= 4 | pages= 599-606 | pmid=16554735 | doi=10.1038/modpathol.3800574 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16554735 }} </ref> | * It is thought that the [[hormone]]-[[receptor]] mechanism mediates the excessive proliferation of epithelial and stromal cells.<ref name="pmid16554735">{{cite journal| author=Sapino A, Bosco M, Cassoni P, Castellano I, Arisio R, Cserni G et al.| title=Estrogen receptor-beta is expressed in stromal cells of fibroadenoma and phyllodes tumors of the breast. | journal=Mod Pathol | year= 2006 | volume= 19 | issue= 4 | pages= 599-606 | pmid=16554735 | doi=10.1038/modpathol.3800574 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16554735 }} </ref> | ||
* Although fibroadenomas may be develop in any part of the [[breast]], there is a significant predilection for the upper outer quadrant. | * Although fibroadenomas may be develop in any part of the [[breast]], there is a significant predilection for the upper outer quadrant. | ||
==Genetics== | ==Genetics== | ||
* The mediator complex subunit 12 (MED12) gene is the most common [[gene]] involved in the pathogenesis of fibroadenoma.<ref name="wiki">Fibroadenoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Fibroadenoma Accessed on January, 29 2016</ref> | * The mediator complex subunit 12 (MED12) gene is the most common [[gene]] involved in the pathogenesis of fibroadenoma.<ref name="wiki">Fibroadenoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Fibroadenoma Accessed on January, 29 2016</ref> | ||
Revision as of 16:39, 14 January 2019
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Fibroadenoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Fibroadenoma pathophysiology On the Web |
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American Roentgen Ray Society Images of Fibroadenoma pathophysiology |
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Risk calculators and risk factors for Fibroadenoma pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]
Overview
Fibroadenoma is a common benign tumor of the breast. Fibroadenoma arises from connective tissue cells, which are cells that are normally involved in the functional and mechanical support of the surrounding tissues. Fibroadenoma demonstrate estrogen and progesterone sensitivity and may grow during pregnancy. The mediator complex subunit 12 (MED12) gene is the most common gene involved in the pathogenesis of fibroadenoma. On gross pathology, a rubbery, tan colored, and lobulated mass is a characteristic finding of fibroadenoma. On microscopic pathology, charectersitic findings of fibroadenoma include a biphasic proliferation of both stromal and epithelial components that can be arranged in two growth patterns; a pericanalicular growth pattern and an intracanalicular growth pattern.[1][2][3][4]
Pathogenesis
- Fibroadenoma is a common benign tumor of the breast.
- Fibroadenoma is a proliferation of stromal and epithelial cells originating from the terminal duct lobular unit.[5]
- Fibroadenoma arises from connective tissue cells, which are cells that are normally involved in the functional and mechanical support of the surrounding tissues.
- The majority of fibroadenomas are benign and do not demonstrate any malignant potential.
- Fibroadenoma demonstrate estrogen and progesterone sensitivity and may grow during pregnancy.[1][2][3][4]
- It is thought that the hormone-receptor mechanism mediates the excessive proliferation of epithelial and stromal cells.[6]
- Although fibroadenomas may be develop in any part of the breast, there is a significant predilection for the upper outer quadrant.
Genetics
- The mediator complex subunit 12 (MED12) gene is the most common gene involved in the pathogenesis of fibroadenoma.[1]
Gross Pathology
- On gross pathology, a painless, firm, solitary, mobile, and slowly growing breast lump is a characteristic finding of fibroadenoma.
- Other charectersitic findings on gross examination of fibroadenoma include:[1][2][3][4]
- Rubbery texture
- Tan/white colored
- Lobulated appearance
- Short slit-like spaces present
- Calcifications
- Fibroadenomas may sometimes be referred to as a "breast mouse", owing to the high mobility of the tumor through out the breast tissue.
Microscopic Pathology
- An overgrowth of fibrous and glandular tissues
- A hypovascular, myxoid, and delicate intalobular stroma
- Calcification may be present
- Absence of mitotic figures, necrosis, and anaplasia
- Biphasic proliferation of both stromal and epithelial components that can be arranged in two growth patterns:
- Pericanalicular growth pattern: stromal proliferation around epithelial structures
- Intracanalicular growth pattern: stromal proliferation compressing the epithelial structures into clefts
- The table below differentiates between the four main subtypes of fibrodenoma according to microscopic histopathological analysis:[2]
| Fibroadenoma Subtype | Description |
|---|---|
| Juvenile fibroadenoma |
|
| Complex fibroadenoma |
|
| Myxoid fibroadenoma |
|
| Cellular fibroadenoma |
|
Gallery
Illustrated below is a series of microscopic images of fibroadenoma:[2]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Fibroadenoma. Wikipedia (2015) https://en.wikipedia.org/wiki/Fibroadenoma Accessed on January, 29 2016
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Fibroadenoma. Libre Pathology (2015) http://librepathology.org/wiki/index.php/Fibroadenoma Accessed on January, 29 2016
- ↑ 3.0 3.1 3.2 3.3 Breast-nonmalignant-Fibroadenoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/breastfibroadenoma.html Accessed on January, 29 2016
- ↑ 4.0 4.1 4.2 4.3 Fibroadenoma. Radiopaedia (2015) http://radiopaedia.org/articles/fibroadenoma-of-the-breast-1 Accessed on January, 29 2016
- ↑ Cerrato F, Labow BI (February 2013). "Diagnosis and management of fibroadenomas in the adolescent breast". Semin Plast Surg. 27 (1): 23–5. doi:10.1055/s-0033-1343992. PMC 3706050. PMID 24872735.
- ↑ Sapino A, Bosco M, Cassoni P, Castellano I, Arisio R, Cserni G; et al. (2006). "Estrogen receptor-beta is expressed in stromal cells of fibroadenoma and phyllodes tumors of the breast". Mod Pathol. 19 (4): 599–606. doi:10.1038/modpathol.3800574. PMID 16554735.