Cytodiagnosis of papillary carcinoma of the breast: Report of a case with histological correlation

Abstract

Papillary lesions of the breast pose diagnostic challenges on aspiration cytology due to overlapping features of benign and malignant entities. Accurate cytologic diagnosis of papillary breast carcinoma cannot usually be made pre-operatively. We present the case of an adult female who underwent fine-needle aspiration (FNA) of a left breast lump. FNA smears were highly cellular showing cohesive clusters, complex papillary fragments and few singly dispersed intact cells. The tumor cells had hyperchromatic nuclei, prominent nucleoli and mild nuclear pleomorphism. A cytologic impression of papillary lesion, possibly malignant (in view of high cellularity, complex papillae and single intact cells) was rendered. The lesion proved to be a papillary carcinoma with microscopic foci of stromal invasion on histologic examination. Papillary carcinoma, an uncommon subtype of breast carcinoma, should be considered while evaluating a papillary lesion with complex branching papillae containing delicate fibrovascular cores and singly lying intact atypical cells.

Cytodiagnosis of papillary carcinoma of the male breast: Report of a case with histological correlation

“…Variable pattern on immunohistochemistry for ER, PR, Her2neu, and Androgen receptors have been reported by different authors. [5678] In the present case, positivity for PR and Her2neu and negativity for ER and S-100 was observed. Ki-67 showed a low proliferative index with the presence of in-situ component and pushing borders rather than infiltrative.…”

“…Micropapillary carcinoma lacks true fibrovascular core and shows angulated papillary and tubuloalveolar pattern of cellular aggregates with single atypical cells. [ 7 ] Smears from the IPC are highly cellular, composed predominantly of discohesive epithelial cells with minimal-to-mild cytological atypia. Malignant lesions lack foamy or hemosiderin-laden macrophages.…”

“…Few authors have demonstrated positivity for Collagen IV, around the IPC, concluding that it is intraductal. [ 9 ] Some pathologists now prefer the term “encapsulated papillary carcinoma” to the more traditional “intracystic papillary carcinoma.”[ 7 ]…”

“…Aspiration of cyst fluid may dilute the cellularity, leading to errors in diagnosis. [ 7 ] Due to its indolent behavior on clinical and radiological examinations, the diagnosis is most often delayed. USG reveals a hypoechoic area indicating the cyst with hyperechoes projecting from the cyst wall indicating the tumor part.…”

Observational study to compare histologically confirmed benign and malignant papillary neoplasm with demographic parameters and features of neoplasm

“…1 Both types are characterized by the presence of fibro-vascular cores (FVC) which are lined by epithelial proliferation with varying degrees of atypia. 2,3 Excision biopsy can be performed for the definite diagnosis of the nature of tumour. However, clear difference cannot be made on aspiration cytology.…”