Diagnostic dilemmas and pitfalls in ThinPrep® cytology of breast fine needle aspiration biopsy
| Autor: | Maria Laureana Santos-Zabala, Marcia Edelweiss, Jose Scarpa Carniello, Fresia Pareja |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty Histology Lobular carcinoma Pathology and Forensic Medicine law.invention 03 medical and health sciences 0302 clinical medicine law Biopsy medicine Carcinoma Atypia skin and connective tissue diseases medicine.diagnostic_test business.industry General Medicine medicine.disease Fibroadenoma 030104 developmental biology Fine-needle aspiration 030220 oncology & carcinogenesis Breast implant business Breast carcinoma |
| Zdroj: | Diagnostic Cytopathology. 45:655-661 |
| ISSN: | 8755-1039 |
| DOI: | 10.1002/dc.23708 |
| Popis: | Fine needle aspirations (FNA) of the breast for primary diagnoses have become less popular in the USA and are usually performed for lesions with low or extremely high clinical suspicion. They are also performed for lesions in close proximity to a breast implant. Liquid-based cytological preparations, such as ThinPrep® (TP), provide a practical alternative to clinicians who are performing FNA. Using a selection of cases that represent challenging diagnoses, we describe common diagnostic pitfalls of breast FNA that are specifically associated with this preparation. Well known breast cytology pitfalls, such as fibroadenoma, when solely examined using a TP slide can be even more challenging since the usual stripped bipolar cells seen in the background of smeared slides, can appear singly dispersed with preserved cytoplasm, resembling carcinoma. We describe that large fragments of solid papillary carcinoma are represented by mostly singly dispersed cells with plasmacytoid features that mimic those of a lobular carcinoma. Since nuclear features are more pronounced in TP, prominent nucleoli and cytological atypia can potentially be overcalled. TP processing might also lead to clumping of epithelioid histiocytes that appear atypical, which increases the suspicion of malignancy. The presence of atypical cells in a TP slide of a peri implant seroma should always undergo additional testing, especially in patients with a prior history of breast carcinoma, to determine if it represents recurrent carcinoma or an implant associated anaplastic large cell lymphoma. Familiarity with the aforementioned artifacts associated with TP is essential to avoid diagnostic misinterpretations. Diagn. Cytopathol. 2017;45:655-661. © 2017 Wiley Periodicals, Inc. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text