BREAST CYTOPATHOLOGY

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86 4. Primary Malignant Tumors• Myoepithelial cells are lacking.• The cribriform type is characterized by cohesive sheetlikefragments of bland cells with sharply punched out holes.The micropapillary form is characterized by abundant largecellular fragments with slender, well-formed papillarystructures with narrow avascular stalks and wide bulbousends. The comedo type is characterized by degenerated/necrotic cellular debris, microcalcifications, foamy macrophages,and pleomorphic malignant cells with a high nucleargrade. The cystic hypersecretory type is characterized bypleomorphic cells with cytoplasmic vacuoles and oftenhobnailed nuclei associated with foamy macrophages,hemosiderin-laden macrophages, cellular debris, and fragmentsof amorphous colloid-like material.• A cytopathologic distinction between ductal carcinomain situ and invasive ductal carcinoma is not possible inmost of the cases. Therefore, traditionally both forms ofcancers are grouped under the broad cytologic category of“mammary carcinoma.”Figure 4.1. Ductal carcinoma. Pleomorphic, hyperchromatic malignantcells are seen in a disorganized architecture. A few singlemalignant cells are present as well. Follow-up biopsy revealed ductalcarcinoma in situ, comedo type. (Smear, Papanicolaou.)
Ductal Carcinoma 87Figure 4.2. Ductal carcinoma. Higher magnification shows markedlypleomorphic malignant cells in a loose cluster. Background showsgranular necrosis and a few macrophages. Follow-up biopsy revealedductal carcinoma in situ, comedo type (Smear, Papanicolaou.)Figure 4.3. Ductal carcinoma. A fragment of pleomorphic malignantcells in a background of prominent necrosis. Numerous singlemalignant cells are seen as well. Follow-up biopsy revealed ductalcarcinoma in situ, comedo type. However, a distinction from infiltratingductal carcinoma could not have been possible with fineneedleaspiration. (Smear, Diff-Quik.)
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Breast Cytopathology
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Syed Z. Ali, MDDepartment of Pathol
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To my parentsGul Bano (late) and Ma
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viiiForewordthis volume to rejuvena
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xSeries Prefaceand form the framewo
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xiiPrefacecarefully selected high-r
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ContentsForeword by Dorothy L. Rose
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2 1. Introduction and Technical Asp
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10 1. Introduction and Technical As
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2Non-neoplastic andProliferative Le
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18 2. Non-neoplastic and Proliferat
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136 4. Primary Malignant Tumorsdiag
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5Metastatic and SecondaryTumorsMeta
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140 5. Metastatic and Secondary Tum
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Figure 5.6. Metastatic small cell c
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BFigure 5.9. (B) Metastatic papilla
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154 6. Breast Ductal LavageTable 6.
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156 6. Breast Ductal LavageFigure 6
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162 6. Breast Ductal Lavagecarcinom
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164 6. Breast Ductal LavageKrishnam
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166 IndexApocrine carcinomain axill
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168 IndexDuctal carcinoma (cont.)fi
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170 IndexFine-needle aspiration, of
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172 IndexLung cancer, 138metastatic
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174 IndexPapilloma (cont.)invasive
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BREAST CYTOPATHOLOGY

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