It has been suggested that lactating adenoma is a variant of lobular hyperplasia, fibroadenoma, or tubular adenoma, which has undergone hormonal influences during lactation. Clinically, it presents as a firm, nontender, and mobile mass that usually regresses spontaneously after the period of lactation. Lactating adenoma is typically seen during late pregnancy through the period of lactation and is a benign stromal tumor. About 3% of breast cancers are diagnosed during pregnancy. Among them, lactating adenoma and fibroadenoma are most prevalent. In late pregnancy and lactation period, the main differential diagnosis for a palpable solid breast mass is lobular hyperplasia which is a normal physiological event, fibroadenoma, focal mastitis, lactating adenoma, tubular adenoma, phyllodes tumor, and breast carcinoma. Subsequent core biopsy demonstrated lobules that are lined by actively secreting epithelial cells with vacuolated cytoplasm, hyperchromatic nuclei, and prominent nucleoli which are features of lactating adenoma, and she was advised to have the mass excised. Color Doppler demonstrated central vascularity, which differentiates the lesion from a galactocele which demonstrates a lack of blood flow. Ultrasonography of the breast revealed a well-defined hypoechoic lesion measuring 2.9 cm × 1.3 cm with well-circumscribed borders, lobulated margins, and increased central vascularity at 2–4 o’ clock position involving the superomedial quadrant of the right breast with its long axis parallel to the chest wall and was categorized as a suspicious lesion (BI-RADS category 4A). The sonographic images were assessed for the presence of solid masses, and if masses were present their shapes, margins, orientations, echo patterns, posterior acoustic features, and surrounding tissue effects were recorded according to the American College of Radiology Breast Imaging-Reporting and Data System (BI-RADS) ultrasound lexicon 5 th edition. There were no axillary lymphadenopathy, skin changes, or nipple discharge. At physical examination, the markedly asymmetric right breast was filled with a firm, painless mass and did not seem to be adherent to the chest wall. There was no family or personal history of breast cancer. ICD-10-CM D12.8 is grouped within Diagnostic Related Group(s) (MS-DRG v41.A 24-year-old primiparous woman, who had been breastfeeding for 6 months, presented with a 2-month history of pain in the right breast since the time she started breastfeeding. A non-metastasizing neoplasm arising from the wall of the rectum.benign carcinoid tumors of the large intestine and rectum ( D3A.02-)īenign neoplasm of colon, rectum, anus and anal canal.Malignant neoplasms of ectopic tissue are to be coded to the site mentioned, e.g., ectopic pancreatic malignant neoplasms are coded to pancreas, unspecified ( C25.9).For multiple neoplasms of the same site that are not contiguous, such as tumors in different quadrants of the same breast, codes for each site should be assigned. 8 ('overlapping lesion'), unless the combination is specifically indexed elsewhere. A primary malignant neoplasm that overlaps two or more contiguous (next to each other) sites should be classified to the subcategory/code.Primary malignant neoplasms overlapping site boundaries.In a few cases, such as for malignant melanoma and certain neuroendocrine tumors, the morphology (histologic type) is included in the category and codes. The Table of Neoplasms should be used to identify the correct topography code. Chapter 2 classifies neoplasms primarily by site (topography), with broad groupings for behavior, malignant, in situ, benign, etc.An additional code from Chapter 4 may be used, to identify functional activity associated with any neoplasm. All neoplasms are classified in this chapter, whether they are functionally active or not.
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