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Thanks to Dr. Lamiaa Rouas, Mohamed V University School of Medicine (Morocco), for contributing this case and the discussion. This case was reviewed in May 2020 by Dr. Jennifer Bennett, University of Chicago and Dr. Carlos Parra-Herran, University of Toronto.
July 15-19, 2013
Snow King Resort
Jackson, Wyoming
30th Annual Summer Update
In Clinical Immunology, Microbiology, and Infectious Diseases
This 24.25 hour review and update in the areas of clinical immunology, microbiology, and
infectious diseases is intended to improve knowledge about the pathogenesis and clinical
manifestations of infectious diseases, immunological mechanisms of disease and disease
prevention, appropriate approaches to the diagnosis of infections and immunologic disorders, and utilization of the clinical microbiology and immunology laboratory including selection and interpretation of results.
This course will provide a forum for the exchange of ideas dealing with microbial infections as well as immunity to infectious diseases and immunologic disorders. Faculty consists of clinicians involved in patient care, pathologists, and clinical laboratory scientists. Discussion of timely topics by faculty and participants assures that this course will be informative, interesting, and relevant.
Course Directors:
Harry R. Hill, MD
Larry G. Reimer, MD
Judy A. Daly, PhD
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(1) For topics with numerous images, we have started putting them in a scrolling frame to make the space more efficient. For an example, please view CD31 and let us know what you think.
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(3) Our Feature Page for May highlights Computer Software and Systems and includes Milestone Medical, PathView Systems and Voicebrook. We also have a new Mystery Case on the right side of the Home Page.
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Case #273
Clinical history:
A 42 year old pregnant woman (G1P0) presented at 30 weeks gestation with an ulcerated nodule on the right labium minus. The lesion had been present for more than a year, but was exaggerated during pregnancy.
Physical examination showed a 2 cm mobile polyp with an ulcerated surface on the right labium minus, but was otherwise normal. There were no palpable breast masses, axillary or cervical lymphadenopathy. The polyp was biopsied.
Clinical images:
Microscopic images:
What is your diagnosis?
Diagnosis: Mammary type fibroadenoma of the vulva
Discussion:
The biopsy revealed appearance polypoid lesion with distinct epithelial and mesenchymal components. The epithelium is organized in ductal elements lined by low columnar uniform epithelium surrounded by a myoepithelial layer. The stromal component is myxoid, with loose connective tissue and scattered inflammatory cells. The polyp surface had granulation tissue and acute inflammatory cells. There was no evidence of malignancy. The findings are in keeping with a fibroadenoma, identical to those seen in the breast.
Ectopic mammary tissue occurs along the primitive milk line, from the axilla to groin. It is considered by some to be a normal constituent of the anogenital area, which undergoes the same pathologic processes as in the breast (Adv Anat Pathol 2011;18:1). Epithelial and fibroepithelial lesions seen in the native breast can also originate in ectopic mammary tissue, such as in this case. Excision is recommended to confirm the diagnosis and provide symptomatic relief (Obstet Gynecol 2011;118:478).
