Afshan H S Fathima, Daniel M Nirmal, Raj A Santhosh, Singh Priyanka, Sigamani Elanthenral
Department of General Pathology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India.
Indian J Pathol Microbiol. 2025 Jan 1;68(1):108-112. doi: 10.4103/ijpm.ijpm_742_23. Epub 2024 Aug 8.
Nipple adenoma (NA) is a rare benign neoplasm of the nipple arising from the lactiferous duct. Often seen in middle aged women, presenting as a nodule, erosive, or ulcerative lesion and associated with serous or bloody discharge. Histologically, they comprise closely arranged tubules with papillary infoldings centered around the lactiferous ducts. It is most likely clinically confused with Paget's disease and histologically with invasive breast carcinoma or its precursor lesions. The aid of immunohistochemistry is valuable in differentiating these entities and to definitively exclude malignancy.
All cases with available slides and blocks, diagnosed as nipple adenoma, during the period of January 2015 to December 2021, will be identified through an appropriate query search from the pathology database. Clinico-radiological details and histopathology will be studied and analyzed. The available follow up data and clinical outcome will be assessed.
Sixteen cases of nipple adenoma were studied and the median age at diagnosis was found to be 37 years. Nipple discharge and swelling were the most common presentations. Ultrasound imaging was done in 14 cases with the median size of lesion being 0.8cms. Seven underwent excision biopsy followed by histopathological examination. The most common histological pattern observed is "adenosis" pattern. Immunostains p63, smooth muscle myosin heavy chain (SMMHC) and CK5/6 were performed. Nine cases were on follow up but none had recurrence.
NA is a benign entity with varied histological patterns. Histopathological examination with the aid of immunohistochemistry helps in diagnosis and to rule out other mimickers. Surgical excision is the treatment of choice.
乳头腺瘤（NA）是一种起源于输乳管的罕见乳头良性肿瘤。常见于中年女性，表现为结节、糜烂或溃疡性病变，并伴有浆液性或血性溢液。组织学上，它们由围绕输乳管紧密排列的小管组成，伴有乳头状折叠。临床上它很可能与佩吉特病混淆，组织学上则与浸润性乳腺癌或其前驱病变混淆。免疫组织化学有助于区分这些实体并明确排除恶性肿瘤。
通过对病理数据库进行适当的查询搜索，确定2015年1月至2021年12月期间所有诊断为乳头腺瘤且有可用切片和组织块的病例。将研究和分析临床放射学细节和组织病理学。评估可用的随访数据和临床结果。
研究了16例乳头腺瘤病例，诊断时的中位年龄为37岁。乳头溢液和肿胀是最常见的表现。14例进行了超声检查，病变的中位大小为0.8厘米。7例接受了切除活检，随后进行组织病理学检查。观察到的最常见组织学模式是“腺病”模式。进行了免疫染色p63、平滑肌肌球蛋白重链（SMMHC）和CK5/6检测。9例进行了随访，但均无复发。
NA是一种具有多种组织学模式的良性实体。借助免疫组织化学的组织病理学检查有助于诊断并排除其他相似疾病。手术切除是首选治疗方法。
