J Korean Soc Radiol.  2018 Feb;78(2):103-106. 10.3348/jksr.2018.78.2.103.

Papillary Apocrine Metaplasia of the Breast Mimicking Papillary Neoplasm: A Case Report

• Ha T
• Yim H
• Park SY
• Kang DK
• Kim TH

• KMID: 2408259
• DOI: http://doi.org/10.3348/jksr.2018.78.2.103

Abstract

Apocrine metaplasia is a benign fibrocystic change characterized by dilated acini lined by columnar cells with apocrine features. These apocrine-like cells form papillary clumps of cells extending into the cystic space called papillary apocrine metaplasia. The researchers report a case of a 48-year-old woman who presented with a palpable mass in the right breast. Breast ultrasonography and MRI showed a large complex cystic and solid mass. A differential diagnosis included intraductal papilloma or intracystic papillary carcinoma. She underwent surgery and the final diagnosis was papillary apocrine metaplasia.

MeSH Terms

Breast*
Carcinoma, Papillary
Diagnosis
Diagnosis, Differential
Female
Humans
Magnetic Resonance Imaging
Metaplasia*
Middle Aged
Papilloma, Intraductal
Ultrasonography, Mammary

Figure

• 

  Fig. 1 A 48-year-old woman with papillary apocrine metaplasia. A. Breast sonography shows an oval, complex cystic and solid mass with internal echogenic debris in the 12 o'clock direction of the right breast. B. Increased blood flow within the mural nodule is noted on color Doppler image. C. On axial fat-saturated T2-weighted image, the cystic mass shows bright signal intensity and the mural nodule shows low signal intensity. D. On dynamic contrast-enhanced study, the mural nodule shows strong contrast enhancement. E. Kinetic curve pattern is initial fast and delayed washout pattern. F. Microscopic examination shows a unilocular cyst lined with a single layer of columnar cells with apocrine feature (arrow) and a small papillary projection of apocrine-like cells (thick arrow) (hematoxylin and eosin stain, × 12.5 and × 100).

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