2003, Number 2
Papiloma intraquístico gigante periférico: Un simulador de BI-RADS V. Presentación de un paciente
Kaffati LFS, Arboleyda NSE, López RJL, Ortíz IMC, Ponte RR, Sánchez CJ, Padilla LR
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Language: Spanish
References: 8
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ABSTRACT
Intraductal papillomas are a common cause of nipple discharge. The diagnosis is usually incidental. In most cases papillomas are solitary lesions localized in the subareolar region inside a principal duct. Occasionally they can appear as multiple lesions found in the periphery ducts. Its presence indicates a higher risk of 1 to 2 times of developing breast cancer than a woman with no pathology. Intraductal papillomas are localized inside the duct, and extend throughout the lumen longitudinally. The rest of the duct may dilate and form a cystic structure which ori- ginates an intracystic papilloma which is a less frequent presentation.By mammography, the vast majority are not visualized because the papilloma is inside the duct. Occasionally they will appear as a well defined, lobulated mass that can be differentiated from other lobulated masses. Its location is predominantly in the anterior portion of the breast and sometimes are found inside a cyst which is identified by mammography. Solitary papillomas of the principal ducts rarely calcify, although after bleeding calcifications may be visualized.
When they are big enough to be seen by ultrasound, a solid, hipoecoic and usually lobulated mass will be seen inside a duct. They are considered low risk lesions, although atypical cells or carcinoma in situ may develop from a papilloma and they may coexist.
By histology, a fibrovascular center is visualized which grows inward with a tree-like configuration. The principal differential diagnosis is with papillary carcinoma. Both lesions are clinically and mammographically indistinguishable. The diagnosis then depends on the clinical, imaging and pathological correlation.
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