BREAST CYTOPATHOLOGY

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118 4. Primary Malignant TumorsPitfalls and Differential Diagnosis• Sometimes difficult to distinguish from cribriform carcinomaof the breast• Infiltrating lobular carcinoma• Immunohistochemistry may be of some value in this distinctionbecause cribriform breast carcinoma is usuallyestrogen and progesterone positive while adenoid cysticcarcinoma is estrogen and progesterone negative• Other mimics may be collagenous spherulosis and pleomorphicadenomaSquamous Cell CarcinomaClinical Features• This entity should include only lesions that are predominantlysquamous and not adenocarcinoma with squamousmetaplasia.• No specific clinical features of squamous cell carcinomadistinguish it from other subtypes.• Squamous cell carcinoma may be a component of metaplasticcarcinoma or may exist as a pure form.• Approximately 10%–15% of pure squamous cell carcinomashave axillary node metastasis.Cytomorphologic Characteristics (Figures 4.40 and 4.41)• Cellular aspirate• May be composed entirely of squamous cells, which arekeratinizing, nonkeratinizing, or spindled• Background keratinous debris and extensive necrosis• Cystic degeneration and hemorrhagePitfalls and Differential Diagnosis• Cytologic appearance of the aspirate may be identical incases of primary breast squamous cell carcinoma versusmetastatic squamous cell carcinoma. Clinical historyplays a key role in the distinction of the former from thelatter.
Special Types of Breast Carcinomas 119Figure 4.40. Squamous cell carcinoma. Poorly differentiated carcinomawith an irregular fragment of pleomorphic malignant cellswith irregular, large, hyperchromatic nuclei. Squamous differentiationwas more evident in other areas with keratinization. (Smear,Papanicolaou.)Figure 4.41. Squamous cell carcinoma. Higher magnification of agroup of malignant cells with pleomorphic nuclei and macronucleoli.Note the well-defined cytoplasmic junctions, the only evidence ofsquamous differentiation in this case. (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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58 3. Benign and Borderline TumorsC
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60 3. Benign and Borderline TumorsF
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Page 100 and 101: 86 4. Primary Malignant Tumors• M
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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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Page 160 and 161: BFigure 5.9. (B) Metastatic papilla
Page 168 and 169: 154 6. Breast Ductal LavageTable 6.
Page 170 and 171: 156 6. Breast Ductal LavageFigure 6
Page 176 and 177: 162 6. Breast Ductal Lavagecarcinom
Page 178 and 179: 164 6. Breast Ductal LavageKrishnam
Page 180 and 181: 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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