A case of invasive ductal carcinoma with multiple osteoclast-like giant cells in fine needle aspiration cytology specimen

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  • 穿刺吸引細胞診で多数の破骨細胞様巨細胞を認めた浸潤性乳癌の 1 例

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Abstract

<p>Background : Breast carcinoma with osteoclast-like giant cells (OGC) are rare, which account for 0.5-1.2% of breast carcinoma cases. Here, we report a case of invasive ductal carcinoma with multiple OGC identified in the cytology specimen.</p><p>Case : A woman in her 30 s noted a 3 cm mass in the BD portion of the right mammary gland. A fine needle aspiration cytology specimen smear showed a combined population of tumor cells and multinucleated giant cells. Epithelial clusters and scattered single glandular cells had hyperchromatic, irregular-shaped, and relatively small nuclei, which are considered as ductal carcinoma cells. The multinucleated giant cells were observed between the epithelial clusters and had 10-40 vesicular nuclei and variable-sized and-shaped ample cytoplasm, suggestive of OGC. Histologic examination revealed atypical epithelial cells proliferate in the solid nests or show a cribriform growth pattern, combined with CD68-immunoreactive OGC. The histological diagnosis was invasive ductal carcinoma, solid type, with OGC. Immunohistochemically, the carcinoma cells were estrogen receptor-positive and progesterone receptor-positive, whereas HER2 was negative.</p><p>Conclusion : OGCs are rarely determined in the breast cytology specimens of mesenchymal tumors and various-histological types of breast carcinoma and most of them are luminal type invasive ductal carcinoma. In such cases, the cytologic diagnosis should be made based on cells other than OGCs.</p>

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