- A Cytomorphologic Study of Benign and Malignant Papillary Neoplasms of the Breast.
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Ho Jung Lee, Gyungyub Gong, Bohng Hee Kim, Sei Hyun Ahn, Jeong Mi Park, Jooryung Huh, Shin Kwang Khang, Jae Y Ro
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Korean J Cytopathol. 1999;10(1):27-34.
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 Abstract
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- Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations.
To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carci nomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papil lomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma.
Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(67%).
Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma.
Malignant lesions tended to show higher cellularity and more single isolated cells.
The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor.
- Cytologic Features of Benign Phyllodes Tumors as Compared to Fibroadenomas of the Breast.
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Jae Hee Suh, Gyung Yub Gong, Jeong Mi park, Sei Hyun Ahn, On Ja Kim
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Korean J Cytopathol. 1996;7(2):151-156.
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Abstract
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- Phyllodes tumor(PT) is a rare distinctive fibroepithelial breast tumor that occasionally shows unpredictable clinical behavior. Wide excision should be the primary treatment of PT and enucleation, the standard procedure for fibroadenoma(FA), is proscribed due to high frequency of local recurrence. Therefore an accurate preoperative diagnosis of PT is essential in order to ensure proper surgical treatment. However, the differentiation between benign PT and FA is often difficult on the basis of cytologic findings.
In an attempt to better understand the cytologic features of benign PT and possibly to differentiate PT from FA on the findings of fine needle aspiration(FNA)smears, we reviewed cytologic smears from 22 histologically diagnosed cases each of benign PT and FA, respectively. The cytologic features assessed were cellularity and atypia of both epithelial and stromal components, and shape of epithelial cell clusters.
Atypia of stromal cells was more frequent in PT, while blunt branching pattern of epithelial cells was more frequent in FA.
The specific cytologic diagnosis of PT is not possible in many cases, but the abundance of stromal cells with moderate nuclear atypia in the correct clinical setting such as older age and larger size(>4cm) allows the diagnosis.
- Value of Fine Needle Aspiration Cytology of Mucinous Carcinoma of the Breast.
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Yoon Jung Kim, Gyung Yub Gong, Joo Ryung Huh, Jeong Mi Park, Sei Hyun Ahn, On Ja Kim
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Korean J Cytopathol. 1996;7(2):157-162.
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Abstract
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- Fine needle aspiration(FNA) is an effective tool in diagnosing mammary carcinoma, We experienced 7 cases of histologically confirmed mammary mucinous carcinoma among 3,052 aspirated cases of breast from 1992 to 1996 in Asan Medical Center" The average age of the patient was 48(33-64) years. The mean size of the lesions was 1.6(0.7-3) cm, and they were palpated as well-defined, firm to hard masses. The cytologic features that may be useful in making a FNA diagnosis of mucinous carcinoma of the breast were analysed.
Mucinous background and tumor cell, clusters with occasional single cells were observed in all cases. Among them, two, cases showed abundant scattered single cells, whereas only few single cells were seen in the other two cases. Tumor cells exhibited mild pleomorphism in four cases, and moderate pleomorphism in three cases. Nucleoli tended to be not prominen and are observed in three cases, rarely noted in other three cases and not seen in one. There was microcalcification in four cases(57%). In conclusion, mucinous background and clustered tumor cells showing mild td moderate pleomorphism with characteristic clinical findings allow us to diagnose, mucinous carcinoma of the breast.
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