Papilloma Breast

Benign papilloma is the single most common cause of serous or bloody discharge from the nipple.Papilloma is a benign mass lesion that results from proliferation of the ductal epithelium that projects in to the lumen of the duct. Papilloma are usually single.These lesions are connected by a fibrovascular stalk to the epithelial lining.They may be located in large or small ducts  and project into the lumen, Although all of these lesions are mostly located  in the major subareolar ducts.Papilloma may show various areas of necrosis, haemorrhage and occassionally calcification. The duct around them may dilate to form a cystic structure giving the appearance of Intracystic papilloma. Mammography may show a dilated duct, or retroareolar haze in case of small masses. If the papilloma is large, then an elongated mass may be seen on mammography. Some times mulberry like calcifications are seen in the retroareolar area on mammography. Ulltrasound plays an important role in the event  of a negative mammogram in patients of bloody discharge from nipple, Because it can still detect a dilated duct and an intraductal solid homogenous mass. MRI of the papilloma shows features similar to Fibroadenomas.