By M.A. Heilperin
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Extra resources for Aspects of the pathology of money: monetary essays from four decades
41 CHAPTER 5 Overview of Radiologic Aspects of Breast Disease A SKIN CHANGES Skin thickening is often accompanied by thickening of the Cooper’s ligaments. Skin and Cooper’s ligament thickening can be caused by tumor, inﬂammation or edema. Skin thickening is the mammographic correlate of the clinical sign ‘peau d’orange’ and may be seen in so called inﬂammatory breast cancer. Skin thickening is often seen associated with breast infections and when there is either venous or lymphatic obstruction within the axilla.
Histology conﬁrmed a 43 mm lobular carcinoma with additional tumor foci behind the nipple. 48 pretation is based on the morphology of the abnormality as well as an assessment of how the lesion enhances following the injection of the MR contrast agent, gadolinium (Figure 5-17). Architectural features that indicate benign disease and malignancy are similar to those already described for mammography and ultrasound. Benign lesions tend to be well-deﬁned with smooth margins whereas malignant lesions are poorlydeﬁned and may show spiculation or parenchymal deformity.
In difﬁcult cases, such as DCIS/LCIS involving areas of sclerosing adenosis, immunohistochemistry can be undertaken to assess whether a myoepithelial and basement membrane layer is indeed present. The ﬁnding of pure DCIS in a core does not, of course, preclude the ﬁnding of an invasive focus in the subsequent surgical excision sample and in approximately 20% of cases it has been reported that a co-existing invasive carcinoma will be seen. One of the beneﬁts of core biopsy is that the diagnosis of special type and low grade carcinomas is not as problematic as this may be on FNAC (Figure 3-11).
Aspects of the pathology of money: monetary essays from four decades by M.A. Heilperin