ADH and Low grade DIC

Dr.Ahmed Raji
F.I.C.M.Path
College of Medicine - University of Babylon

The currently accepted definition of ADH is that of

a lesion with cytological and architectural features indistinguishable from those of low-grade DCIS

, that is, monomorphic cells with ovoid to rounded nuclei and the formation of micropapillae, tufts, fronds, bridges, solid, and/or cribriform patterns within the involved space .

but either

intimately admixed with UDH.

or

(2) showing only partial involvement of the TDLU.
Quantitative requirements have been proposed for

when there is complete involvement of the space(s) involved , namely to be ?2 mm or to be present in fewer than two adjacent spaces.

a diagnosis of low-grade DCIS would be rendered if these same cells involved two or more spaces or measured >2 mm.

The alternative view, masterfully articulated by Azzopardi and currently supported by many experts,

is that proliferative breast disease can be divided into distinct categories:

the “usual” hyperplasia category

And

the intraductal carcinoma category, which may be further subdivided into a low-grade and a high-grade pathway.

Ductal intraepithelial neoplasia (DIN)

Grades:
UDH: usual ductal hyperplasia
DIN 1A: flat epithelial atypia
DIN 1B: atypical ductal hyperplasia
DIN 1C: DCIS grade 1 (low grade)
DIN2: DCIS grade 2 (intermediate grade)
DIN3: DCIS grade 3 (high grade)