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Pathology Infectious Disease bc44cc1c

Juvenile papillomatosis is caused by:

A
HPV
B
B, EBV
C
CMV
D
Herpes virus
High-Yield Explanation
Ref: Rabbins Pathologic Basis of Disease. 8th editionExplanation:Juvenile Papillomatosis of the breast* It is a relatively common benign localised proliferative lesion in the breast.* It is mainly seen in young women (mean age: 19-23 years)* Caused by HPV 6 and 11.Clinical presentation* Patients present with a firmt well-defined, mobile mass often in the periphery of the breast.* There is usually no nipple discharge.Pathology* Papillary proliferation of the ductal epithelium which partly fills up smaller ducts causing distension.* Grossly, well-circumscribed mass containing multiple small cysts (<2 cm) within a dense fibrous stroma (therefore sometimes termed swiss cheese disease by pathologists).* Lesions can vary in size, usually ranging from 1 to 8 cm.Radiographic featuresBreast ultrasound* They can appear as an ill-defined, inhomogenous hypoechoic mass with multiple small (up to 4mm) predominantly peripheral cysts.* Microcalcifications may be seen at sonography.Mammography* These lesions are usually negative on mammography.* Occasionally may show microcalcifications, an asymmetric density or a prominant intraductal pattern.Galactography* May show a multiple irregular filling defects within the breasts.Breast MRISignal characteristics according to one report include* T1 : hypo-intense lobulated mass* T2 : may show- presence of multiple small internal cysts, best shown on this sequence and is considered the most specific feature* T1 C+ (Gd) : may or may not show marked rapid enhancement* Dynamic sequence: shows a benign enhancement profile.Complications* Despite being a benign entity, it is considered by some to be a marker for familial breast cancer.* Approximately /0% develop breast cancer later in life.

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