Böcker W, Hungermann D, Tio J, Weigel S, Decker T
Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Domagk-Str. 17, 48159, Münster, Deutschland.
Pathologe. 2009 Feb;30(1):36-41. doi: 10.1007/s00292-008-1123-y.
According to the WHO, flat epithelial atypia (FEA) is defined as a neoplastic epithelial proliferation of ductal type in either a single or in multiple terminal duct lobular unit(s) limited to the periphery of the ductules in a clinging growth pattern. The atypical cells may form between one and several layers of epithelial cells that show low grade cytologic atypia. FEA most often presents as mammographic microcalcifications, which are typically round (secretory type and psammomatous calcification in an eosinophilic matrix, so-called ossifying calcifications). Clinical relevance is dependent on whether the lesion appears in isolation or whether it is an excision biopsy or a minimally invasive biopsy. Currently available data suggest that the risk of subsequent breast carcinoma in the ipsilateral breast is very low following the diagnosis of FEA. The differential diagnosis should include atypical ductal hyperplasia, low-grade clinging ductal carcinoma in situ, blunt duct adenosis and apocrine metaplasia.
根据世界卫生组织的定义,扁平上皮异型增生(FEA)是指单个或多个终末导管小叶单位内的导管型肿瘤性上皮增生,以贴壁生长方式局限于小导管周边。异型细胞可形成一层至数层显示低级别细胞学异型性的上皮细胞。FEA最常表现为乳腺钼靶微钙化,通常为圆形(分泌型及嗜酸性基质中的砂粒体钙化,即所谓的骨化性钙化)。其临床相关性取决于病变是孤立出现,还是切除活检或微创活检。目前可得数据表明,FEA诊断后同侧乳腺后续发生乳腺癌的风险非常低。鉴别诊断应包括非典型导管增生、低级别贴壁型导管原位癌、钝圆导管腺病和大汗腺化生。