乳房的硬化性病变包括一系列良性和恶性实体,通常构成诊断挑战。在形态学和免疫表型评估中,了解关键形态学特征和陷阱对于避免过度诊断或诊断不足并确保最佳临床管理至关重要。本文综述了非肿瘤性硬化性病变,如放射状瘢痕/复杂硬化性病变,硬化性腺病,硬化性导管内乳头状瘤,导管腺瘤和乳头腺瘤的硬化性变异,和伴有广泛硬化的纤维腺瘤,包括他们的临床表现,特征形态,鉴别诊断注意事项,适当的免疫组织化学检查,当需要时,以及临床意义。此外,非典型或肿瘤性实体(如非典型导管增生,导管原位癌,低级别腺鳞癌,还简要讨论了可能涉及这些硬化性病变的纤维瘤样化生癌)。
Sclerosing lesions of the breast encompass a spectrum of benign and malignant entities and often pose a diagnostic challenge. Awareness of key morphologic features and pitfalls in the assessment of morphology and immunophenotype is essential to avoid over- or underdiagnosis and ensure optimal clinical management. This review summarizes nonneoplastic sclerosing lesions such as radial scar/complex sclerosing lesion, sclerosing adenosis, sclerosing intraductal papilloma, sclerosing variants of ductal adenoma and nipple adenoma, and fibroadenoma with extensive sclerosis, including their clinical presentation, characteristic morphology, differential diagnostic considerations, appropriate immunohistochemical work-up, when needed, and the clinical significance. In addition, atypical or neoplastic entities (such as atypical ductal hyperplasia, ductal carcinoma in situ, low-grade adenosquamous carcinoma, and fibromatosis-like metaplastic carcinoma) that can involve these sclerosing lesions are also briefly discussed.