[153] Fibroadenomatous Lesions in Pediatric Age Group

Sara Faiz, Vladislav Tudor, Gokmen-Polar Yasim, Sunil Badve. Indiana University School of Medicine, Indianapolis, IN

Background: Fibroadenomatous lesions (FAs) are well described in adults but the morphological features are poorly characterized in the pediatric age group (age<18). We investigated the morphological features of FAs in this age group.
Design: From January 1999 to December 2011, 119 cases with the diagnosis of fibroadenoma in females age 18 years or younger were identified and were reviewed by two pathologists. FAs were divided into different groups based on their morphological appearance into tubular (epithelial rich), classic, cellular (increased stromal cellularity), juvenile (epithelial hyperplasia), and mixed types and phyllodes tumor (stromal overgrowth) on the basic of predetermine criteria.
Results:

Patient Demographic and Histopathology of Fibroadenoma
Type of FibroadenomaTubular n= 18Cellular n=12Classic n=62Juvenile n=18Tub&Classic n=5Phyllodes n=4
Mean Age ( yrs)161516141516
Race (W/B/others)4/14/03/9/034/22/68/7/32/3/01/3/0
Tubular adenosis(Y/N)2/160/120/620/180/50/4
Sclerosing Adenosis (Y/N)0/180/120/620/180/50/4
Cystic dilatation(Y/N)2/163/95/577/113/21/3
Epithelial Hyperplasia(Y/N)0/180/120/6218/00/50/4
Mitosis/10hpf≤1=16, ≤3=1, ≤5=1≤1=8, ≤2=4<≤1=56, ≤3=6≤1=11, ≤3=5, ≤5=2≤1=5≤5=4
Cellularity(H/M/L)12/6/012/0/00/55/713/5/02/3/04/0/0
Increase periductal cellularity (Y/N)10/85/735/2717/13/24/0
Ratio of stroma to epithelium<1=18<1=4, 1=6, >1=2<1=2, 1=57,>1=3<1=2, 1=10, >1=3<1=2, 1=3>1=4
Intracanalicular (I), pericanalicular (P)P13, I+P=5P=4, I=2, I+P=6P=7, I=23,I+P=32P=4, I=2, I+P=12P=2, I+P=3I+P=4
Periepithelial infitrate (Y/N)6/123/99/536/121/22/2
Types of stroma[ Fibrous=F, Periductal and fibrous interductal=PFIND, Hyaline=H, Myxoid=M]F=12, PFIND=6F=7,PFIND=3, H=1, M=1F=4, M=16, PFIND=42F=6, M=1, PFIND=11F=3, PFIND=2F=4
W=White, B= Black, H=High, M=Medium, L=low, Y=yes, N=No, hpf=high power field

Fibroadenoma is the frequent lesion in pediatric age group with classic FA being the most common type. Cases with overlapping features were present. Complex fibroadenomas were extremely unusual with only rare cases exhibiting fibrocystic changes. Mitoses were observed in all subtypes. Stromal overgrowth was the only feature that reliably distinguished FA from phyllodes tumor.
Conclusions: Epithelial hyperplasia is a cardinal feature of Juvenile FA. Stromal mitosis is a very common finding in pediatric FELs and does not necessitate a diagnosis of phyllodes tumor.
Category: Breast

Monday, March 4, 2013 1:00 PM

Poster Session II # 45, Monday Afternoon

 

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