WCAFTI: Worrisome cytologic alterations following tissue infarction; a mimicker of malignancy in breast cytology

Abstract

The acronym WCAFTI (cafti)-(Worrisome cytologic alterations following tissue infarction) is introduced here for the first time for the entity which describes the spectrum of cytologic changes seen in spontaneous infarction of an epithelial lesion. The pathology may be responsible for abnormal cytologic findings such as cellular dyshesiveness, nuclear enlargement with cytoplasmic blurring and irregular nuclei. Although, it is a rare event, it is essential for a cytologist to be aware of this new acronym WCAFTI to avoid misinterpretation of atypical cells and necrosis as indicators of malignancy. It is typically described here in a fibroadenoma from a 49-year-old female who sought medical help for pain in left breast mass.

Extensive Multifocal Mammary Infarction - a Case Report

“…The specific cause of mammary infarction has yet to be definitively established, however, theories include vascular insufficiency and localized thrombosis [3]. Accurate diagnosis is critical since breast infarction can histologically appear similar to carcinoma, thus potentially leading to an incorrect diagnosis and treatment by the physician [4]. We present a rare case of a 27-year-old female with extensive, multifocal, bilateral mammary infarction.…”

Spontaneous infarction in fibroadenoma of breast: a rare pathological finding in a common pathological entity

“…In case of inflammatory lesion like tuberculous granulomatous mastitis, the differentiation is possible by the presence of epithelioid cell granulomas, multinucleated giant cells, lymphocytes and ZN staining of AFB. [22][23][24][25][26][27][28] Other commonest differential diagnosis like duct ectasia, clinical presentation of subareolar cord like mass helps in the correct diagnosis. 22,26,29 Histopathological examination is the confirmatory investigation for infarction of fibroadenoma which shows abundant areas of ischemic necrosis, haemorrhagic areas with partial or no retain of the architecture of the fibroadenoma.…”

Spontaneous Infarction of Multiple Fibroadenoma in a Postlactational Woman: Case Report

“…Özellikle ince iğne aspirasyon sitolojisi/iğne biyopsisi, frozen kesit gibi sınırlı yöntemler kullanıldığında, memenin yangısal hastalıkları ve nekrotik karsinomları ile karıştırılabilmektedir. [3][4][5][6] İnfarktlı fibroadenomlar çoğunlukla hassasiyet gösteren, ağrılı kitleler olarak tespit edilirler. Bu özellikleriyle klinik olarak memenin yangısal hastalıklarına benzerler.…”

“…5 Frozen kesit ve rutin hematoksilen eozin (HE) kesitlerinde ise, nekroz, hayalet hücreler ve zor seçilebilen yapısal patern nedeniyle, fibroadenomda infarkt durumları, memenin karsinomları ile karışıklığa neden olabilmektedir. [3][4][5][6] Lezyonun kenarlarında ince hat halinde infarktsız fibroadenomun izlenmesi, infarktlı kısımlarda fibroadenoma özgü yapının seçilebilmesi temel tanısal bulgulardır. 3 Nekrotik alanlarda retikülin boyası ile epitelyal komponentte bazal membran varlı-ğının gösterilmesi tanıda yardımcı olabilir.…”