Ibrahim Mansoor, Pathologist at King’s College Hospital London, Jeddah, shared on X:
”Juvenile or cellular fibroadenoma? Does the name really matter?
A 30-year-old woman. Multiple breast masses since age 20. Repeated excisions. Different pathologists, different diagnoses!
- Some lesions called cellular fibroadenoma.
- Others show features of juvenile fibroadenoma.
- Now, two enlarging breast masses raise concern for phyllodes tumour!
Under the microscope:
- Cellular but relatively bland spindle-cell stroma
- Prominent epithelial hyperplasia
- Focal bizarre-looking stromal nuclei
- Low mitotic activity
- No convincing stromal overgrowth
So, juvenile or cellular fibroadenoma?
Here’s the fascinating part!
Juvenile fibroadenoma is not exclusively a disease of teenagers. It describes a characteristic morphological pattern, often combining cellular stroma with prominent epithelial proliferation.
Cellular fibroadenoma emphasizes the stromal component.
The two can overlap!
But the bigger question isn’t juvenile vs cellular.
Could we be missing a benign phyllodes tumour?
Rapid growth, cellularity and even low mitotic activity cannot reliably settle this distinction on core biopsy.
The lesson: Sometimes two pathologists use different names for overlapping benign morphology. What matters most is identifying the lesion’s biological behaviour and ensuring appropriate clinical management.
Pathologists: Would you call this juvenile fibroadenoma, cellular fibroadenoma, or simply a benign fibroepithelial lesion?”
Other interesting articles about breast oncology on OncoDaily.
