TỔN THƯƠNG NHÚ Ở VÚ: PHÂN LOẠI THEO WHO 2022 VÀ THÁCH THỨC TRONG CHẨN ĐOÁN GIẢI PHẪU BỆNH

Abstract

Papillary lesions of the breast represent a complex and heterogeneous group of entities with a broad morphological spectrum ranging from benign and atypical lesions to invasive malignancies. According to the 5th edition (2022) classification by the World Health Organization, these lesions are categorized into six entities: intraductal papilloma, papilloma with atypical hyperplasia or ductal carcinoma in situ, papillary ductal carcinoma in situ, encapsulated papillary carcinoma, solid papillary carcinoma, and invasive papillary carcinoma. This review aims to update the histopathological diagnostic criteria based on the WHO 2022 classification and to discuss the challenges encountered in routine practice, including the distinction between benign lesions and low-grade malignancies, the role of immunohistochemistry in assessing myoepithelial cells, the limitations of core needle biopsy, and common diagnostic pitfalls such as infarction-related changes. A thorough understanding of classification criteria and the appropriate use of immunohistochemical markers is essential for improving diagnostic accuracy and guiding clinical management.