Signification and problems on estimating histologic types of the breast tumors by fine needle aspiration cytology. Fine needle aspiration cytology of noninvasive ductal carcinoma of the breast.

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  • KOREMATSU Motoko
    Division of Pathology, Saitama Social Insurance Hospital
  • SHIMIZU Ken
    Department of Anatomic and Diagnostic Pathology, Dokkyo-kyo University School of Medicine

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  • 乳腺穿刺吸引細胞診における組織像推定の意義と問題点　　非浸潤性乳管癌の細胞像　　出現パターンからみた分類と鑑別診断
  • 出現パターンからみた分類と鑑別診断

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Objective: We clarified cytological characteristics and diagnostic criteria for noninvasive ductal carcinomas (NIDC) of the breast, focusing on weak cytological atypiam in fine needle aspiration cytology (FNAC).<BR>Study Design: We reviewed 56 preoperative FNAC specimens of histologically proven NIDC, compared to 10intraductal papillomas (IDP) and 10 fibroadenomas (FA).<BR>Results: NIDC was divided into 4 groups: a) NIDC with weak cytological atypism and IDP-like epithelial clusters, showing papillary or cribriform clusters with nuclear overlapping; b) NIDC with weak atypism and FA-like clusters, showing sheet-like or tubular arrangement; c) NIDC with marked atypism, often indistinguishable from invasive car cinoma: and d) NIDC with special cytological features. To differentiate IDP-like NIDC from IDP, it was important to find variable-sized clusters, irregular overlapping, and high cellularity in clusters, and loose-bound clusters. Loss of biphasic patterns of epithelial and myoepithelial cells and irregular nuclear overlapping in clusters were effective findings suggesting FA-like NIDC.<BR>Conclusion: In FNAC specimens, NIDC with weak cytological atypism can be differentiated from benign disease by checking the cytological features of epithelial clusters.

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