BREAST CYTOPATHOLOGY

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78 3. Benign and Borderline Tumors• Some of the variants of lipoma that have been described inthe breast include fibrolipoma, angiolipoma, hibernoma,and spindle cell limpoma.Cytomorphologic Characteristics• Hypercellular smears• Mature adipose tissueDifferential Diagnosis and Pitfalls• Fibrocystic changes, papillomatosisMyofibroblastomaClinical Features• Myofibroblastoma is a benign spindle cell neoplasm ofbreast stroma and is composed of myofibroblasts.• The patients range in age from 40 to 87 years, with a meanage of 65 years.• Patients usually present with a slow-growing solitarymass.• This lesion affects men and women.• Mammography reveals a relatively well-circumscribedsolid mass, usually lacking microcalcifications.Cytomorphologic Characteristics• Predominantly spindle-shaped cells with occasional ovalcells• Spindled myofibroblasts with well-formed nuclear groovesand/or intranuclear inclusions• Rare mitotic figures• Desmin-, actin-, and vimentin-positive cells
Pitfalls and Differential Diagnosis• Fibrocystic changes, papillomatosis• Pseudoangiomatous stromal hyperplasia• Inflammatory myofibroblastic tumorAdenomyoepithelioma 79AdenomyoepitheliomaClinical FeaturesAdenomyoepithelioma is a rare breast tumor characterizedby a biphasic proliferation of epithelial and myoepithelialcells. The tumor has a low malignant potential. Therefore,an accurate FNA diagnosis is clinically important for patientmanagement. The tumor is well-known for its histologicheterogeneity, which is reflected in an often diagnosticallydifficult cytopathologic interpretation. Three subtypes havebeen described according to their growth pattern and predominantcell type: tubular, lobular, and spindle. Most casesbehave in a benign fashion but can recur locally if incompletelyexcised. Close follow-up is always required evenafter excision.Cytomorphologic Characteristics(Figure 3.24 to 3.28)• Smears are moderate to hypercellular.• Cohesive fragments of epithelial and myoepithelial cellsoccur in varying proportions.• Epithelial cells display cohesive sheets and rarely tubuleswith uniform nuclei containing grooves.• Myoepithelial cells have a variegated appearance withspindle, epithelioid, clear cell, and plasmacytoid morphology.They appear as cohesive fragments, single cells withwell-preserved clear and vacuolated “soap bubble” cytoplasm,or as naked bipolar nuclei in the background. Occasionalintranuclear inclusions are seen.
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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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128 4. Primary Malignant TumorsFigu
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130 4. Primary Malignant TumorsPitf
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132 4. Primary Malignant TumorsFigu
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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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