PMC4356184_01
Radiological and histopathological features of case 1, right breast. (A) Right mediolateral oblique view: distortion of breast parenchyma between the upper quadrants showing inhomogeneous density and star-like appearance, but no radio-opaque nucleus. (B, C) Irregular mass between the upper quadrants exhibiting heterogeneous hyperintensity in sagittal T2-weighted images (FSE with fat saturation) (B) and hyperintensity on DW (Diffusion Weighted) sequences (b value 600 s/mm2) without diffusion restriction (C). (D) Irregular mass with spiculated margins showing rim enhancement and persistent enhancement in the sagittal subtraction images obtained before and after contrast medium administration. (E) Histopathological examination: fibrocystic breast tissue with a sclerosing adenosis lesion and columnar cell metaplasia/hyperplasia.
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Hamburg) using an 11-gauge needle. Histolopathological examination demonstrated fibrocystic breast tissue where an SA lesion was associated with columnar cell metaplasia/hyperplasia and subacute-chronic inflammation at both intra- and extraductal sites also involving histiocytes (Figure 1A-1E).
PMC4356184_02
Radiological and histopathological features of case 2, left breast. (A) Regional clumped non-mass-like enhancement in the superomedial quadrant in the subtraction image obtained before and after contrast medium administration. (B) Only a few microcysts are depicted at the site of the non-mass-like enhancement in the sagittal T2-weighted image (FSE with fat saturation). (C) At the same site, DW (Diffusion Weighted) sequences (b value 600 s/mm2) show an area of inhomogeneous hyperintensity with diffusion restriction. (D) MIP (maximum intensity projection) image showing non-mass-like enhancement associated with asymmetrically increased vascularity. (E) Histopathology: complex sclerosing adenosis lesion associated with usual ductal hyperplasia (UDH) and florid UDH.
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Histolopathological examination of 6 tissue samples collected in US-guided vacuum-assisted biopsy (Ethicon Endo-Surgery) using an 11-gauge needle at our institution demonstrated a complex SA lesion associated with epithelial proliferation that was reminiscent of usual ductal hyperplasia (UDH) including florid and papillary aspects as well as columnar cell metaplasia/hyperplasia with evidence of flat epithelial atypia (Figure 2A-2E).