BREAST CYTOPATHOLOGY

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62 3. Benign and Borderline TumorsFigure 3.7. Fibroadenoma. Numerous well-defined tubules of atypicalductal epithelium mimic tubular carcinoma. However, the presenceof abundant myoepithelium is extremely helpful in accuratelydiagnosing this lesion as benign. (Smear, Papanicolaou.)Figure 3.8. Fibroadenoma. The presence of abundant mucin is anuncommon finding in this tumor and may create diagnostic confusionwith colloid carcinoma. However, the lack of overt malignantepithelial characteristics and the presence of abundant myoepithelialcells exclude carcinoma. In these cases the source of mucin isthought to be either epithelial mucin from dilated glandular lumensor mucinous change of the stromal matrix. (Smear, Papanicolaou.)
Phyllodes Tumor 63• Low-grade ductal carcinoma (particularly tubular carcinoma)• Mucinous carcinomaPhyllodes TumorA phyllodes tumor is a rare fibroepithelial breast tumor oftendistinguished from fibroadenoma by the presence of a moreprominent and cellular mesenchymal component. It is amajor differential diagnosis of a breast lesion with a significantspindle cell or mesenchymal component. Although mostphyllodes tumors are benign, low-grade (borderline) andmalignant subtypes are occasionally encountered. Their preoperativedistinction from fibroadenomas (which is not alwayspossible) is considered clinically significant, as phyllodestumors are resected with a wider negative margin in order toavoid tumor recurrence.Clinical Features• Occurrence is rare, accounting for 0.3%–1% of primarybreast tumors.• Peak incidence is seen much later in life than fibroadenoma(45–50 years).• Most patients present with a unilateral slowly enlargingbreast mass, with an average size of 5 cm.• Approximately 15%–20% of phyllodes tumors recur afterexcision.Cytomorphologic Characteristics(Figures 3.9 to 3.13)• Hypercellular smears, biphasic but more often epithelialpredominant(in benign tumors), with large stromal fragments(“phyllodes fragments”), often in an anatomizing/branching pattern
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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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112 4. Primary Malignant TumorsFigu
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116 4. Primary Malignant TumorsPitf
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120 4. Primary Malignant TumorsInfl
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122 4. Primary Malignant Tumors•
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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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