Stromal Cellular Fragments in Breast Fine Needle Aspirates: Think Outside of the Box

2018 ◽  
Vol 62 (5-6) ◽  
pp. 450-455
Author(s):  
Rui Caetano Oliveira ◽  
Fernando C. Schmitt
Keyword(s):  
Differential Diagnosis ◽  
Mammary Carcinoma ◽  
Giant Cells ◽  
The Other ◽  
Low Grade ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Epithelial Component ◽  
Phyllodes Tumour ◽  
Epithelial Lesion

Background: The presence of highly cellular stromal fragments in breast fine needle aspirates (FNA) suggests some classical differential diagnoses such as cellular fibroadenoma, phyllodes tumour (PT), metaplastic carcinomas, and some mesenchymal/myoepithelial proliferations. The other components of the smears can help in the differential diagnosis, but the presence of a low-grade epithelial proliferation does not always represent a fibro-epithelial lesion as we demonstrate in these two cases. Cases: We discuss two cases of breast FNA, previously presented in a slide seminar at the 29th European Congress of Pathology in Amsterdam, where the common cytological finding was the presence of stromal cellular fragments together with an epithelial component. One case is a typical PT and the other is a case of a mammary carcinoma with osteoclast-like giant cells. Conclusion: Mammary carcinoma with osteoclast-like giant cells is an unusual type of breast carcinoma that should be included in the differential diagnosis of breast lesions containing cellular stroma. Since the associated carcinoma is usually low grade, careful evaluation for malignant cells on cytological smears is necessary for an accurate differential diagnosis with PT where the epithelial component is benign.

Atypical Hidradenoma Mimicking Primary Mammary Carcinoma on Breast Fine-Needle Aspiration: A Case Report with Long-Term Follow-Up

2016 ◽  
Vol 60 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Lisa M. Rooper ◽  
Jeffrey S. Iding ◽  
Jonathan D. Cuda ◽  
Syed Z. Ali
Keyword(s):  
Differential Diagnosis ◽  
Fine Needle Aspiration ◽  
Mammary Carcinoma ◽  
Needle Aspiration ◽  
Partial Mastectomy ◽  
Low Grade ◽  
Fine Needle ◽  
Nuclear Atypia ◽  
Long Term Follow Up ◽  
Palpable Breast

Background: Fine-needle aspiration (FNA) is well-established as an accurate technique for the diagnosis of palpable breast masses. While the differential diagnosis of such lesions usually focuses on benign or malignant mammary proliferations, a subset of breast neoplasms arises from skin and soft tissue. Skin adnexal neoplasms such as hidradenoma can pose a particular pitfall on breast FNA cytology (FNAC) as epithelial proliferations that are not of ductal or lobular origin. Case: A 59-year-old female presented with a superficial breast mass. FNAC revealed a hypercellular lesion with marked nuclear atypia that was highly suspicious for carcinoma. However, at partial mastectomy, the histological features of the tumor were consistent with atypical hidradenoma. Negativity for estrogen receptor (ER) and progesterone receptor (PR) confirmed the diagnosis. Eighteen years later, the patient remains free of recurrence or metastasis. Conclusions: This report offers the first description of findings of atypical hidradenoma on FNAC. In the breast, its high cellularity and nuclear atypia can mimic a primary mammary carcinoma on FNAC. Although breast and skin adnexal tumors show a immunohistochemical overlap, negative ER and PR stains in a low-grade tumor can suggest a nonmammary lesion. Skin adnexal neoplasms should be considered in the differential diagnosis of superficial breast tumors.

Differential Diagnosis of Hürthle Cell Neoplasms on Fine Needle Aspirates

1997 ◽  
Vol 41 (1) ◽  
pp. 197-208 ◽  
Author(s):  
Stefan E. Pambuccian ◽  
Robert L. Becker, Jr. ◽  
Syed Z. Ali ◽  
Kay Savik ◽  
Dorothy L. Rosenthal
Keyword(s):  
Differential Diagnosis ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Hürthle Cell

Diagnostic Frequency Ratios Are Insufficient to Measure Laboratory Precision with The Bethesda System for Reporting Thyroid Cytopathology

2015 ◽  
Vol 59 (3) ◽  
pp. 225-232 ◽  
Author(s):  
Roghayeh Fazeli ◽  
Eric B. Schneider ◽  
Syed Z. Ali ◽  
Martha A. Zeiger ◽  
Matthew T. Olson
Keyword(s):  
Tertiary Hospital ◽  
The Other ◽  
Observer Variability ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
Bethesda System ◽  
Thyroid Cytopathology ◽  
The Bethesda System ◽  
Frequency Ratios ◽  
Undetermined Significance

Objective: Diagnostic frequency ratios such as the atypia of undetermined significance (AUS):malignant ratio are touted to be useful for laboratory precision benchmarking. We therefore sought to examine their reproducibility and usefulness at a tertiary hospital. Methods: We reviewed thyroid fine-needle aspirates (FNA) submitted to our institution from outside laboratories and evaluated the ability of diagnostic frequency ratios to capture the complexity of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Specifically, we evaluated the ability of the AUS:malignant ratio to describe the frequencies of the other TBSRTC diagnoses. Results: A total of 2,784 cases from 19 laboratories were included. The use of the AUS category varied the most. There was insufficient reflection of the non-AUS nonmalignant TBSRTC diagnostic frequencies in our analysis, and these results do not appear to arise from observer variability in the outside laboratories. Conclusion: Diagnostic frequency ratios are not reproducible in our experience and fail to describe the other TBSRTC categories. As such, they are unlikely to prove sufficient for benchmarking laboratory precision with TBSRTC.

Multinucleated Giant Cells in Fine Needle Aspirates

2002 ◽  
Vol 46 (5) ◽  
pp. 823-827 ◽  
Author(s):  
Pei-Ling Tsou ◽  
Yung-Lian Hsiao ◽  
Tien-Chun Chang
Keyword(s):  
Giant Cells ◽  
Multinucleated Giant Cells ◽  
Fine Needle ◽  
Fine Needle Aspirates

scholarly journals Fine-needle aspiration cytopathology-An accurate diagnostic modality in mammary carcinoma with osteoclast-like giant cells

2010 ◽  
Vol 118 (6) ◽  
pp. 468-473 ◽  
Author(s):  
Solène-Florence Jacquet ◽  
Corinne Balleyguier ◽  
Jean-Rémi Garbay ◽  
Céline Bourgier ◽  
Marie-Christine Mathieu ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
Mammary Carcinoma ◽  
Giant Cells ◽  
Needle Aspiration ◽  
Diagnostic Modality ◽  
Fine Needle
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