We present the case of a 73-year-old woman with an epithelial-myoepithelial carcinoma of the left breast (ie, malignant adenomyoepithelioma). In both the initial needle core biopsy and in the subsequently performed lumpectomy, the tumor consisted of nests of neoplastic epithelium and myoepithelium with cytologic atypia, increased mitoses, and infiltrative growth into the surrounding tissue. Mutational analysis showed oncogenic driver mutations in HRAS and PIK3CA. In this article, we describe an epithelial-myoepithelial carcinoma of the breast with focal metaplastic differentiation, an extremely rare entity, and report the results of targeted next-generation sequencing. Our patient has not shown any evidence of recurrent or metastatic disease at 29 months follow-up.
Background
The tall cell variant of papillary thyroid carcinoma (PTC‐TC) has been associated with aggressive features including extrathyroidal extension, higher rate of lymph node and distant metastases, and higher recurrence rate. We aimed to evaluate the cytomorphologic features of PTC‐TC on ThinPrep (TP) along with its diagnostic efficacy to detect PTC‐TC.
Methods
Preoperative cytology samples from 30 cases of histologically‐proven PTC‐TC and 30 classical PTC controls were selected for this study. TP preparations were evaluated for varying architectural and cytomorphologic features.
Results
Tall cells were present in the majority of PTC‐TC cases and were located at the periphery of cell clusters and as single cells. Cytoplasmic cuff along the periphery of cell clusters and soap‐bubble pseudoinclusions were very specific features of PTC‐TC, when present. PTC‐TC cases were more likely to show abundant oncocytic cytoplasm and distinct cell borders. Cytoplasmic tails were more likely to be present and more numerous in PTC‐TC. The presence of nuclear grooves, papillary architecture, and giant cells were not reliable distinguishing features of PTC‐TC vs controls.
Conclusion
Our results indicate that tall cell cytomorphologic and architectural features in PTC are identifiable on TP.
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