BREAST CYTOPATHOLOGY

120 4. Primary Malignant Tumors
Inflammatory Carcinoma
Clinical Features
• Inflammatory carcinoma refers to a particular form of
breast carcinoma with an unusual presentation.
• Most cases have a prominent dermal lymphatic infiltration
by tumor cells.
• The reported frequency of inflammatory carcinoma ranges
from 1% to 10%.
• The age distribution is similar to that of ductal carcinoma
NOS.
• Common clinical findings include diffuse erythema, induration,
warmth, tenderness, edema, and, occasionally, a palpable
mass.
Cytomorphologic Characteristics
• There is no significant inflammatory cell infiltrate.
• The inflammatory presentation is due to edema, which
is the result of lymphatic obstruction by the tumor
cells.
• The underlying infiltrating carcinoma has no specific features
and is similar to poorly differentiated ductal carcinoma
NOS
• There is usually low cellularity because of the edema. Onsite
evaluation is imperative to ensure an adequate sample
for diagnosis.
• Cells occur singly or in loose clusters.
• There is fine cytoplasmic vacuolization.
• Pleomorphic nuclei with macronucleoli are present.
• Tumor diathesis occurs.
Pitfalls and Differential Diagnosis
• Acute mastitis/abscess
• Pregnancy/lactational changes