C5: Malignant
This category indicates an adequate sample showing cells characteristic of carcinoma, or other malignancy. Malignancy should never be diagnosed on the basis of a single criterion. Combinations of the features listed in the following table will be always necessary to achieve the diagnosis. Criterion Benign Malignant General characteristics Cellularity Usually poor or moderate Usually high […]
Gynaecomastia
Gynaecomastia Gynaecomastia is a hormonally dependent lesion appearing most often in adolescents and older male patients. It can be classified as juvenile, idiopathic or drug-related. Cytological diagnostic features Low to moderate cellularity Groups of ductal cells Occasional apocrine cells Occasional mild nuclear atypia and nucleoli Stromal bipolar naked nuclei
Medullary carcinoma
Medullary carcinoma Medullary carcinoma is a rare type of breast carcinoma, usually occurring in the fifth and sixth decade of life. It characteristically presents as a well-demarcated lesion. Medullary carcinoma has been thought to have a better prognosis than ductal carcinoma NOS, although some studies have suggested that this is not true. Cytological diagnostic features […]
Evaluation of the specimen
Evaluation of nipple secretions Evaluation of FNA specimens Evaluation of nipple secretions A nipple discharge may be unilateral or bilateral; unilateral ones are more likely to be malignant. The secretion can be milky, serous, purulent or bloody. Cancer is most prevalent when the discharge is macroscopically bloody. Benign nipple secretions – cytologic diagnostic features Usually […]
Radiation change
Radiation change FNA cytology of irradiated breast tissue can be a diagnostic challenge. Histological changes include epithelial atypia in the terminal duct-lobular units and in larger ducts. Therefore, having knowledge of prior irradiation therapy is crucial to avoid a false-positive diagnosis of malignancy. FNA smears show atypical cells with nuclear and cytoplasmic enlargement and degenerative […]
Benign lesions
Benign lesions Breast cysts Mastitis Subareolar abscess Fat necrosis Fibrocystic change Fibroadenoma Papilloma Pregnancy and lactational changes Gynecomastia Radiation change
Breast carcinoma
Breast carcinoma Invasive ductal carcinoma, Not Otherwise Specified (NOS) Invasive Lobular carcinoma Intraductal carcinoma (DCIS) Medullary carcinoma Mucinous (colloid) carcinoma Tubular carcinoma Adenoid cystic carcinoma Papillary carcinoma Other rare variants of breast carcinoma
Cysts
Cysts The most common lesions of the breast are solitary and multiple cysts. Aspiration of the cysts is an excellent procedure for both diagnosis and treatment. Following aspiration of the cyst, it is important to palpate the area again to determine whether a residual mass is present, and if so, additional aspirations of the residual […]
Ductal carcinoma, Not Otherwise Specified (NOS)
Invasive ductal carcinoma, Not Otherwise Specified (NOS) Invasive ductal carcinoma is the most common type of breast carcinoma, accounting for approximately 75% of all invasive carcinoma. FNA specimens of ductal carcinoma, Not Otherwise Specified (NOS) usually show cytological features common to all breast carcinomata. Cytological diagnostic features High cellularity Loosely cohesive groups and single atypical […]
Mastitis
Mastitis FNA cytology of acute mastitis shows yellowish or greenish fluid with numerous neutrophils and foamy macrophages, with abundant background debris. Epithelial atypia resulting from the acute inflammatory process can be seen. Atypical epithelial cells can show features of regeneration and repair, with groups of cells arranged in a flat, streaming pattern with maintainance of […]