BREAST CYTOPATHOLOGY

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126 4. Primary Malignant TumorsFigure 4.44. Metaplastic carcinoma. A hypercellular smear withnumerous dissociated and spindled cells in a myxoid background.The cytopathologic appearance of this rare tumor can often bedeceptively bland. (Smear, Papanicolaou.)Figure 4.45. Metaplastic carcinoma. Higher magnification of thesarcomatoid variant displaying somewhat uniform mesenchymaltypecells with fusiform nuclei. Note the blunt nuclear edges and themitotic figures. (Smear, Papanicolaou.)
Special Types of Breast Carcinomas 127Figure 4.46. Metaplastic carcinoma. A dispersed population ofpleomorphic malignant cells appearing as naked nuclei embeddedwithin a granular, myxoid background. This myxoid stroma shouldnot be confused with the biphasic appearance of a fibroadenoma.(Smear, Diff-Quik.)Carcinoma With Osteoclastic-Type Giant CellsClinical Features• This is a rare variant of high-grade ductal carcinoma NOSand is characterized by the presence of osteoclastic giantcells in the stroma.• A majority of the reported cases had lymph node metastasis,with a 5-year survival rate approaching 70%, similar topatients with ordinary infiltrating breast carcinomas.• The giant cells are present in the stroma and are associatedwith an inflammatory, fibroblastic response with extravasatedred blood cells, lymphocytes, and monocytes.• The giant cells are histiocytic in origin as confirmed bypositive staining for CD68 (KP-1) using immunohistochemistry.The histiocytic nature of these giant cells hasalso been confirmed by ultrastructural studies.Cytomorphologic Characteristics (Figure 4.47)• Hypercellular smears• Osteoclastlike giant cells admixed with carcinoma cells
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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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68 3. Benign and Borderline Tumors
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74 3. Benign and Borderline Tumors
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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 118 and 119: 104 4. Primary Malignant Tumors•
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Page 150 and 151: 136 4. Primary Malignant Tumorsdiag
Page 152 and 153: 5Metastatic and SecondaryTumorsMeta
Page 154 and 155: 140 5. Metastatic and Secondary Tum
Page 158 and 159: Figure 5.6. Metastatic small cell c
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
Page 182 and 183: 168 IndexDuctal carcinoma (cont.)fi
Page 184 and 185: 170 IndexFine-needle aspiration, of
Page 186 and 187: 172 IndexLung cancer, 138metastatic
Page 188 and 189: 174 IndexPapilloma (cont.)invasive
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BREAST CYTOPATHOLOGY

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