Usual ductal hyperplasia

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Author: Mikael Häggström [note 1]

Gross examination

As per:

or mastectomy.

Microscopic evaluation

Usual ductal hyperplasia is typically a cohesive proliferation with haphazard, jumbled cell arrangement or streaming growth pattern. Cells have mild variation in cellular and nuclear size and shape.[1]

Differential diagnosis

In contrast to usual ductal hyperplasia (UDH), atypical ductal hyperplasia (ADH) displays:[1]

  • Increased amounts of pale eosinophilic to amphophilic cytoplasm with conspicuous cell borders
  • Atypical architectural patterns, including cribriform spaces, Roman arches, trabecular bars and micropapillae

If uncertain, immunohistochemistry can be performed:[1]

Usual ductal hyperplasia (UDH) Atypical ductal hyperplasia (ADH)
High molecular weight keratins Mosaic to occasionally diffuse Negative
Estrogen receptor Heterogenous staining Diffusely positive


  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

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  1. 1.0 1.1 1.2 Sofia Lérias, M.D., Melinda Lerwill, M.D.. Usual ductal hyperplasia. Pathology Outlines. Last author update: 11 February 2021. Last staff update: 25 April 2022

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