Difference between revisions of "Breast cytopathology"

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Breast cytopathology (view source)

Revision as of 00:22, 26 December 2014

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→‎Cytology
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| Flat sheets & fluffy paucicellular (fibrous) tissue
| Flat sheets & fluffy paucicellular (fibrous) tissue
| '''Mixed pop. in cluster'''; nuclei: oval/spindle (myoepi.) and round (epi.).
| '''Mixed pop. in cluster'''; nuclei: oval/spindle (myoepi.) and round (epi.).
| [http://commons.wikimedia.org/wiki/File:Breast_fibroadenoma_by_fine_needle_aspiration_%282%29_PAP_stain.jpg Fibroadenoma - FNA (WC)], [http://commons.wikimedia.org/wiki/File:Breast_fibroadenoma_by_fine_needle_aspiration_%281%29_DG_stain.jpg Fibroadenoma FNA - Diff-Quik (WC)], [http://www.flickr.com/photos/jian-hua_qiao_md/3975095095/ Fibroadenoma (flickr.com)]
| [[Image:Breast_fibroadenoma_by_fine_needle_aspiration_%282%29_PAP_stain.jpg | thumb | 150px | center | Fibroadenoma - FNA (WC)]]
|-
|-
| Fibrocystic change
| Fibrocystic change
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| May have flat sheets of cells
| May have flat sheets of cells
| Oncocytic change (apocrine change) common, histocytes (foamy cytoplasm), [[nucleoli]], large NCR
| Oncocytic change (apocrine change) common, histocytes (foamy cytoplasm), [[nucleoli]], large NCR
| [http://commons.wikimedia.org/wiki/File:Fibrocystic_changes_of_breast_-_cytology_1.jpg Oncocytes in FCC (WC)]
| [[Image:Fibrocystic_changes_of_breast_-_cytology_1.jpg |thumb|150px | center | Oncocytes in FCC. (WC)]]
|-
|-
| Papillary neoplasm
| Papillary neoplasm
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| Sheets, usu. flat?
| Sheets, usu. flat?
| Variable size, nucleolus
| Variable size, nucleolus
| [http://commons.wikimedia.org/wiki/File:Breast_papillary_neoplasm_1.jpg Papillary neoplasm (WC)]
| [[Image:Breast_papillary_neoplasm_1.jpg|thumb|150px| center | Papillary neoplasm. (WC)]]
|-
|-
| Ductal carcinoma
| Ductal carcinoma
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| '''3-D clusters'''
| '''3-D clusters'''
| Nuclear size variation, '''membrane irreg.''', nucleoli (prominent) - every cell, cell size var.
| Nuclear size variation, '''membrane irreg.''', nucleoli (prominent) - every cell, cell size var.
| [http://commons.wikimedia.org/wiki/File:Ductal_carcinoma_-_cytology.gif Ductal carcinoma - animation showing 3-D nature (WC)]
| [[Image:Ductal_carcinoma_2_-_cytology.jpg |thumb|150px |center | Ductal carcinoma. (WC)]]
|}
|}


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*Myospherulosis - due to exposure to fat, may be seen in the context of malignancy.<ref name=pmid11035579>{{Cite journal  | last1 = Chau | first1 = KY. | last2 = Pretorius | first2 = JM. | last3 = Stewart | first3 = AW. | title = Myospherulosis in renal cell carcinoma. | journal = Arch Pathol Lab Med | volume = 124 | issue = 10 | pages = 1476-9 | month = Oct | year = 2000 | doi = 10.1043/0003-9985(2000)1241476:MIRCC2.0.CO;2 | PMID = 11035579 }}</ref>
*Myospherulosis - due to exposure to fat, may be seen in the context of malignancy.<ref name=pmid11035579>{{Cite journal  | last1 = Chau | first1 = KY. | last2 = Pretorius | first2 = JM. | last3 = Stewart | first3 = AW. | title = Myospherulosis in renal cell carcinoma. | journal = Arch Pathol Lab Med | volume = 124 | issue = 10 | pages = 1476-9 | month = Oct | year = 2000 | doi = 10.1043/0003-9985(2000)1241476:MIRCC2.0.CO;2 | PMID = 11035579 }}</ref>


Images:
====Images====
*[http://www.ajronline.org/content/192/3/815/F1.expansion.html Early fat necrosis (ajronline.org)].
*[http://www.ajronline.org/content/192/3/815/F1.expansion.html Early fat necrosis (ajronline.org)].
*[http://www.ajronline.org/content/192/3/815/F4.expansion.html Mid fat necrosis (ajronline.org)].
*[http://www.ajronline.org/content/192/3/815/F4.expansion.html Mid fat necrosis (ajronline.org)].
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**Exceptions are ''tubular carcinoma'' and ''colloid carcinoma''; these have cells found in clusters or tubules/glands.<ref name=Ref_APBR678>{{Ref APBR|678}}</ref>
**Exceptions are ''tubular carcinoma'' and ''colloid carcinoma''; these have cells found in clusters or tubules/glands.<ref name=Ref_APBR678>{{Ref APBR|678}}</ref>
*Intracytoplasmic "lumens"/inclusions (think ''lobular carcinoma'').
*Intracytoplasmic "lumens"/inclusions (think ''lobular carcinoma'').
*A useful rule of thumb: strongly suggestive of malignant ~3x RBC diameter & dyscohesive.<ref>Chan, S. 26 April 2012.</ref>


DDx:
DDx:
*[[Breast cytopathology#Fibroadenoma|Fibroadenoma]].
*[[Breast cytopathology#Fibroadenoma|Fibroadenoma]].


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Ductal_carcinoma_-_cytology.gif Ductal carcinoma - animation showing 3-D nature (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Ductal_carcinoma_2_-_cytology.jpg Ductal carcinoma (WC)].
Image:Ductal_carcinoma_-_cytology.gif | Ductal carcinoma - animation showing 3-D nature. (WC)
Image:Ductal_carcinoma_2_-_cytology.jpg | Ductal carcinoma. (WC)
</gallery>
 
==Lobular carcinoma==
{{Main|Invasive lobular carcinoma}}
===Cytology===
Features:
*Discohesive, small, plasmacytoid cells.
*Targetoid mucin - '''key features'''.
 
==Tubular carcinoma==
{{Main|Tubular carcinoma of the breast}}
===Cytology===
Features:
*Tubular structure with sharp point - '''key feature'''.
 
==Mucinous carcinoma==
{{Main|Mucinous carcinoma of the breast}}
===Cytology===
Features:
*Mucin - blue/gray acellular material.
*Nuclear atypia.
 
DDx:
*Mucocele.


==Fibroadenoma==
==Fibroadenoma==
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***Nuclei typically ovoid, may be spindle-shaped.
***Nuclei typically ovoid, may be spindle-shaped.


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Breast_fibroadenoma_by_fine_needle_aspiration_%282%29_PAP_stain.jpg Fibroadenoma - FNA (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Breast_fibroadenoma_by_fine_needle_aspiration_%281%29_DG_stain.jpg Fibroadenoma FNA - Diff-Quik (WC)].
Image:Breast_fibroadenoma_by_fine_needle_aspiration_%282%29_PAP_stain.jpg | Fibroadenoma - FNA (WC)
Image:Breast_fibroadenoma_by_fine_needle_aspiration_%281%29_DG_stain.jpg | Fibroadenoma FNA - Diff-Quik (WC)
</gallery>
www:
*[http://www.flickr.com/photos/jian-hua_qiao_md/3975095095/ Fibroadenoma (flickr.com)].


==Apocrine metaplasia/fibrocystic changes==
==Apocrine metaplasia/fibrocystic changes==
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**Vacuolated cytoplasm + round/oval nuclei.
**Vacuolated cytoplasm + round/oval nuclei.


Image:
====Image====
*[http://commons.wikimedia.org/wiki/File:Fibrocystic_changes_of_breast_-_cytology_1.jpg Oncocytes in FCC (WC)].
<gallery>
Image:Fibrocystic_changes_of_breast_-_cytology_1.jpg | Oncocytes in FCC. (WC)
</gallery>


==Paget's disease==
==Paget's disease==
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*Fibroadenoma - has single cells without cytoplasm.
*Fibroadenoma - has single cells without cytoplasm.


Image:
====Image====
*[http://commons.wikimedia.org/wiki/File:Breast_papillary_neoplasm_1.jpg Papillary neoplasm (WC)].
<gallery>
Image:Breast_papillary_neoplasm_1.jpg | Papillary neoplasm. (WC)
</gallery>


==Apocrine metaplasia==
==Apocrine metaplasia==
Michael
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