WBR0724: Difference between revisions
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|ExamType=USMLE Step 1 | |ExamType=USMLE Step 1 | ||
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|Prompt=A 58 year old woman, previously healthy, presents to the physician's office for a breast lump that she discovered incidentally while showering. Upon further questioning, she reports that she never visits her primary care physician and does not undergo yearly mammography screening. Appropriate work-up is initiated; needle biopsy of the mass is performed and that diagnosis of comedocarcinoma of the breast is made. Which of the following pathological findings is characteristic of comedocarcinoma of the breast? | |Prompt=A 58 year old woman, previously healthy, presents to the physician's office for a breast lump that she discovered incidentally while showering. Upon further questioning, she reports that she never visits her primary care physician and does not undergo yearly mammography screening. Appropriate work-up is initiated; needle biopsy of the mass is performed and that diagnosis of comedocarcinoma of the breast is made. Which of the following pathological findings is characteristic of comedocarcinoma of the breast? | ||
|Explanation=Ductal carcinoma in situ (DCIS) contains several subtypes that are classified based on the architecture of the proliferation: | |Explanation=Ductal carcinoma in situ (DCIS) contains several subtypes that are classified based on the architecture of the proliferation: | ||
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Richie RC, Swanson JO. Breast cancer: a review of the literature. J Insur Med. 2003; 35:85-101. | Richie RC, Swanson JO. Breast cancer: a review of the literature. J Insur Med. 2003; 35:85-101. | ||
|AnswerA="Indian file" pattern | |AnswerA="Indian file" pattern | ||
|AnswerAExp="Indian file" pattern is the linear alignment of lobular cancerous cells that infiltrate through the dense fibrous stroma. It is characteristic of lobular carcinoma. | |AnswerAExp="Indian file" pattern is the linear alignment of lobular cancerous cells that infiltrate through the dense fibrous stroma. It is characteristic of lobular carcinoma. |
Revision as of 02:03, 23 October 2013
Author | [[PageAuthor::Rim Halaby, M.D. [1]]] |
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Exam Type | ExamType::USMLE Step 1 |
Main Category | MainCategory::Pathology |
Sub Category | SubCategory::Oncology |
Prompt | [[Prompt::A 58 year old woman, previously healthy, presents to the physician's office for a breast lump that she discovered incidentally while showering. Upon further questioning, she reports that she never visits her primary care physician and does not undergo yearly mammography screening. Appropriate work-up is initiated; needle biopsy of the mass is performed and that diagnosis of comedocarcinoma of the breast is made. Which of the following pathological findings is characteristic of comedocarcinoma of the breast?]] |
Answer A | AnswerA::"Indian file" pattern |
Answer A Explanation | AnswerAExp::"Indian file" pattern is the linear alignment of lobular cancerous cells that infiltrate through the dense fibrous stroma. It is characteristic of lobular carcinoma. |
Answer B | AnswerB::Neutrophilic infiltration |
Answer B Explanation | AnswerBExp::Neutrophilic infiltration is typical of inflammatory conditions, such as acute mastitis. |
Answer C | AnswerC::Cystic features |
Answer C Explanation | AnswerCExp::Cystic features are characteristic of fibrocystic change/fibrocystic disease. |
Answer D | AnswerD::Cribriform structures |
Answer D Explanation | AnswerDExp::Cribriform structures are seen in cribriform subtype of ductal carcinoma in situ (DCIS). |
Answer E | AnswerE::Central necrosis |
Answer E Explanation | AnswerEExp::Central necrosis is characteristic of comedocarcinoma of the breast |
Right Answer | RightAnswer::E |
Explanation | [[Explanation::Ductal carcinoma in situ (DCIS) contains several subtypes that are classified based on the architecture of the proliferation:
1- Comedo 2- Cribriform 3- Micropapillary 4- Solid 5- Mixed Comedocarcinoma of the breast is characterized by the presence of cancerous cells surrounded by central necrosis. It is considered a more malignant form of DCIS than other types and is in between a state of in-situ cancer and an invasive one. It is frequently detected by mammography. Educational Objective: Comedocarcinoma of the breast is characterized by the presence of central necrosis. Reference: Pinder SE. Ductal carcinoma in situ (DCIS) pathological features, differential diagnosis, prognostic factors, and specimen evaluation. Modern Pathology. 2010; 23:S8-S13. Richie RC, Swanson JO. Breast cancer: a review of the literature. J Insur Med. 2003; 35:85-101. |
Approved | Approved::No |
Keyword | WBRKeyword::breast, WBRKeyword::cancer, WBRKeyword::comedo, WBRKeyword::carcinoma, WBRKeyword::comedocarcinoma, WBRKeyword::indian, WBRKeyword::file, WBRKeyword::central, WBRKeyword::necrosis, WBRKeyword::cribriform, WBRKeyword::subtype, WBRKeyword::DCIS, WBRKeyword::ductal, WBRKeyword::carcinoma, WBRKeyword::in situ, WBRKeyword::cystic |
Linked Question | Linked:: |
Order in Linked Questions | LinkedOrder:: |