BREAST CYTOPATHOLOGY

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72 3. Benign and Borderline TumorsFigure 3.20. Intraductal papilloma. Cytologically atypical epitheliumuniformly arranged around a fibrovascular core. Numerous,loosely cohesive atypical epithelial cells are seen in the background,admixed with myoepithelial cells. This case was called atypicaland turned out to be a papilloma on follow-up resection. (Smear,Papanicolaou.)Figure 3.21. Intraductal papilloma. Higher magnification showsthe extreme degree of cytologic atypia that can be seen in suchlesions. The epithelial cells display enlarged, crowded, and pleomorphicnuclei that are totally disorganized and show prominentnucleoli. Rare myoepithelial cell nuclei are also present. (Smear,Papanicolaou.)
Ductal/Nipple Adenoma 73Breast Lesions Diagnosed as “Papillary”on Fine-Needle AspirationTrue papillary lesions of the breast comprise a diversegroup of benign and malignant entities. A number ofstudies have shown that most of these turn out to be “nonpapillary”on histologic resection (particularly the malignantcases). This, therefore, raises the question, Do we tendto overinterpret “papillary architecture” on FNA? Papillarylesions were considered an “indeterminate” category at theNational Cancer Institute–sponsored consensus conferencein 1996.• Benign follow-up (in two thirds of cases) Intraductal papilloma Papillomatosis Fibroadenoma Fibrocystic changes (with papillary hyperplasia)• Malignant follow-up (one third of cases) Ductal carcinoma (both in situ and invasive) Phyllodes tumorDuctal/Nipple AdenomaAlso known as papillary adenoma, ductal/nipple adenomais a benign mass lesion of the nipple with a prominentpapillary architecture. Most adenomas present with nippledischarge.Clinical Features• This uncommon neoplasm presents as a discrete, sharplycircumscribed nodule with a sclerotic stroma. Most ductaladenomas are up to 2 cm in size and are either solitary ormultiple but rarely bilateral.
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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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20 2. Non-neoplastic and Proliferat
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122 4. Primary Malignant Tumors•
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124 4. Primary Malignant TumorsPitf
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126 4. Primary Malignant TumorsFigu
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130 4. Primary Malignant TumorsPitf
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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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