BREAST CYTOPATHOLOGY

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42 2. Non-neoplastic and Proliferative LesionsFigure 2.25. Collagenous spherulosis. Histologic section illustrat -ing at high magnification the source of the amorphous globularstructures seen in a fine-needle aspiration smear of this entity. Notethe presence of well-defined myoepithelial cells surrounding thesepale eosinophilic structures. (Histologic section, hematoxylin andeosin.)• Lack of significant cellular atypia, lack of basaloid natureof the accompanying epithelium• Occasional papillary ductal epithelial fragments or associatedchanges of a benign papilloma• Diagnostic confusion with adenoid cystic carcinoma maylead to a false-positive diagnosis of cancer on FNAPitfalls and Differential Diagnosis• Adenoid cystic carcinoma• Ductal carcinoma in situ, cribriform type• Adenomyoepithelioma, tubular variant
Pregnancy/Lactational Changes andLactational AdenomaClinical Features• These changes and adenomas are uncommonly encountered.• Fine-needle aspiration distinction between lactationalchange and lactating adenoma is difficult (if at allpossible).• The lesions may lead to an erroneous false-positive diagnosisof carcinoma because of the atypical cytologicfeatures. A careful clinical history of pregnancy/lactationshould always be sought when rendering a diagnosis ofcarcinoma in a younger patient.Cytomorphologic Characteristics(Figures 2.26 to 2.30)Pregnancy/Lactational Changes 43• Hypercellular smears, “yielding” FNAs• Loosely cohesive ductal or, more often, lobular epithelialfragments• More intact lobular fragments in lactating adenoma, oftenwith prominent secretory changes (cytoplasmic vacuoles);prominent outer myoepithelial cell layer• Usually larger cells, with prominent nucleoli andfoamy cytoplasm; cytoplasm is extremely fragile andwispy• Numerous round, naked nuclei in the background (epithelialcell nuclei), often with prominent nucleoli• Numerous inflammatory cells (mostly mature polymorphouslymphocytes), few macrophages• Proteinaceous and frothy slide background, often hemorrhagic,obscuring cellular detailsPitfalls and Differential Diagnosis• Galactocele• Fibroadenoma, tubular adenoma• Atypical ductal hyperplasia, atypical lobular hyperplasia
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Breast Cytopathology
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Syed Z. Ali, MDDepartment of Pathol
Page 6 and 7: To my parentsGul Bano (late) and Ma
Page 8 and 9: viiiForewordthis volume to rejuvena
Page 10 and 11: xSeries Prefaceand form the framewo
Page 12 and 13: xiiPrefacecarefully selected high-r
Page 14 and 15: ContentsForeword by Dorothy L. Rose
Page 16 and 17: 2 1. Introduction and Technical Asp
Page 24 and 25: 10 1. Introduction and Technical As
Page 30 and 31: 2Non-neoplastic andProliferative Le
Page 32 and 33: 18 2. Non-neoplastic and Proliferat
Page 58 and 59: Figure 2.26. Lactational change. Hy
Page 72 and 73: 58 3. Benign and Borderline TumorsC
Page 74 and 75: 60 3. Benign and Borderline TumorsF
Page 82 and 83: 68 3. Benign and Borderline Tumors
Page 98 and 99: 84 3. Benign and Borderline TumorsG
Page 100 and 101: 86 4. Primary Malignant Tumors• M
Page 102 and 103: 88 4. Primary Malignant TumorsFigur
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92 4. Primary Malignant TumorsHisto
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94 4. Primary Malignant TumorsFigur
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100 4. Primary Malignant TumorsFigu
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104 4. Primary Malignant Tumors•
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116 4. Primary Malignant TumorsPitf
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120 4. Primary Malignant TumorsInfl
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134 4. Primary Malignant TumorsClin
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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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