Diagnostic Dilemma in Cytologic Features of Micropapillary Carcinoma of the Breast

Kelten, Esra Canan; Akbulut, Metin; Duzcan, Suleyman Ender

doi:10.1159/000325355

Cited by 5 publications

(9 citation statements)

References 20 publications

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“…Jaffer et al [28], Jimenez-Ayala [29], Kelten et al [30] and Pettinato et al [31] when describing IMPC reported the lack of macropapillary structures [28,29,30,31]. Although we did not have any IMPC in our study, we had 2 low-grade DCIS cases and 1 low-grade infiltrating ductal carcinoma which were associated with a benign papilloma.…”

Section: Discussionmentioning

confidence: 58%

The Conundrum of Papillary Breast Lesions within the C3 Category

Weigner

Zardawi²,

Braye³

et al. 2015

Acta Cytologica

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Objectives: To identify features that could define papillary ductal cell proliferation within the C3 category and to subcategorise papillary lesions into benign papillomas which can be managed conservatively and atypical/malignant papillary neoplasms which require surgical intervention. Study Design: A blind microscopic rescreen of all C3 cases was conducted. The corresponding histological outcome was compared with the cytology. Statistical analysis was performed using papillary versus non-papillary outcomes and benign versus atypical/malignant papillary lesions. In addition, macropapillary lesions (papilloma and encysted papillary carcinoma) were plotted against micropapillary ductal carcinoma in situ. Results: Two hundred thirty FNA cases reported as C3 included 72 papillary neoplasms (52 benign papillomas and 20 atypical/malignant papillary lesions). Features specific to papillary lesions within C3 include macropapillary fragments, complex sheets, palisading strips, cystic background, cohesion and a decreased nuclear-to-cytoplasmic ratio. Features favouring atypical/malignant papillary lesions include decreased numbers of bare bipolar nuclei, discohesion and a non-cystic background. These features are common to most breast malignancies; however, identification of papillary features often results in a downgraded diagnosis from C5. Conclusions: This study supports the ability to reliably identify papillary ductal cell proliferation within C3. Certain features can distinguish papillary lesions from other C3 pathologies. This separation is likely to be clinically useful as papillary lesions may require a different management approach.

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Section: Discussionmentioning

confidence: 58%

The Conundrum of Papillary Breast Lesions within the C3 Category

Weigner

Zardawi²,

Braye³

et al. 2015

Acta Cytologica

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“…In addition to borderline serous carcinoma of the ovary, MPC has also been identified in other sites, such as the stomach, colon and parotid gland, over the last two decades (2–10). Despite its rarity, it deserves extra attention by virtue of its aggressive course.…”

Section: Discussionmentioning

confidence: 99%

“…The reverse polarity (inside-out growth) is the typical histological characteristic of the tumor that is likely to be essential in its pathogenesis. The direct contact between the secretory surface and the surrounding stroma is also likely to facilitate disease spread (2–10,12). …”

Section: Discussionmentioning

confidence: 99%

“…FNA is a relatively easy biopsy method with a number of documented cases of breast MPC diagnosed using this approach (10,13,14). However, few cases of MPC in the urinary bladder have been reported, possibly due to the inapplicability of FNA and the availability of urine as the only cytological sample (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…This is predominantly due to the increasing use of fine needle aspiration (FNA) biopsy, particularly in the parenchymal organs, which allows earlier diagnosis of this aggressive tumor (8–10). The early diagnosis of MPC with FNA biopsy may also be useful in uncommon sites, such as the parotid gland and pericardium.…”

Section: Introductionmentioning

confidence: 99%

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Cytological features of pure micropapillary carcinoma of various organs: A report of eight cases

Huq¹,

Canberk

Öznur

et al. 2014

Oncology Letters

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Micropapillary carcinoma (MPC) is a rare aggressive tumor, which generally accompanies the primary carcinoma of the organ of its origin, while the pure form is extremely uncommon. Angiolymphatic involvement is widespread and a considerable proportion of the cases present with metastases. The current study presents eight pure MPC cases arising from the breast (n=3), urinary bladder (n=3), parotid gland (n=1) and lung (n=1, presenting with pericardial effusion), with the cytological findings. The eight patients included three female and five male cases aged between 48 and 74 years. The most common cytological findings were three-dimensional aggregates, cell clusters with angulated or scalloped borders, single cells with a columnar configuration and eccentric nuclei, and high-grade nuclear features. Histopathological sections showed accompanying in situ ductal carcinoma in the cases of MPC arising in the parotid gland and breast (n=3), and one case in the bladder exhibited only in situ MPC. The average follow-up period was 20 months (range, 6–54 months) and, during this period, three patients succumbed to the disease. At present, four patients are alive with disease and one patient is alive and disease-free. In conclusion, cytology is an important tool for the diagnosis and management of MPC.

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