BREAST CYTOPATHOLOGY

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96 4. Primary Malignant TumorsFigure 4.17. Ductal carcinoma. A high-grade pleomorphic tumorwith singly dispersed naked nuclei. The nuclei are pleomorphic withprominent irregularity of the membrane and devoid of nucleoli. Afollow-up biopsy revealed an infiltrating ductal carcinoma. (Smear,Papanicolaou.)Pitfalls and Differential Diagnosis• Atypical ductal hyperplasia (see Figure 4.11)• Fibroadenoma• Papilloma/papillomatosis• Lobular carcinoma• Metastatic cancersLobular CarcinomaLobular Carcinoma In SituClinical Features• Usually an incidental pathologic finding because it doesnot form a palpable or mammographically detectablelesion
Lobular Carcinoma 97• Seen in premenopausal age• Multicentric and often bilateral• Often associated with atypical lobular hyperplasia• Increased risk of developing invasive carcinomaCytomorphologic Characteristics (Figures 4.18 and 4.19)• Moderately cellular• Epithelial fragments, often depicting intact lobularstructures• Myoepithelial cell layer present around the intact neoplasticlobules• Small cells, tightly packed with monomorphic round nuclei,scant cytoplasm• Intracytoplasmic vacuoles or lumina, sometimes with targetoidmucin vacuoles• Because the cytopathologic features of lobular carcinomain situ are often shared with invasive lobular carcinoma,Figure 4.18. Lobular carcinoma. A well-formed, cohesive fragmentof uniform hyperchromatic malignant cells. A lobular architectureis clearly evident. A follow-up biopsy revealed lobular carcinoma insitu. (Smear, Papanicolaou.)
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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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Figure 2.26. Lactational change. Hy
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Page 72 and 73: 58 3. Benign and Borderline TumorsC
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Page 100 and 101: 86 4. Primary Malignant Tumors• M
Page 102 and 103: 88 4. Primary Malignant TumorsFigur
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Page 152 and 153: 5Metastatic and SecondaryTumorsMeta
Page 154 and 155: 140 5. Metastatic and Secondary Tum
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BFigure 5.9. (B) Metastatic papilla
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148 5. Metastatic and Secondary Tum
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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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