We report a case of neuroendcrine (NE) carcinoma in the right breast of a 67-year-old female, ultrasonography revealed a lesion composed of irregular hypoechoic masses and mammography showed asymmetric breast tissue. Histopathologic examination of the surgical sample showed a solid to nested proliferation of plasmacytoid cells that showed immunocytochemical positivity for chromogranin A, synaptophysin, CD56, and estrogen receptor. Our case was diagnosed as solid NE carcinoma. Though the findings of fine needle aspiration cytology reflected the histological features, we were not able to cytopathologic grounds only to predict the NE nature of this tumor. We performed immunocytochemistry using Chromogranin A, Synaptophysin, and CD56 on our cytologic smear retrospectively with positive results for all of the markers. When the cytopathologic examination of a given breast neoplasm is suggestive of NE differentiation, immunocytochemical staining for NE markers is generally useful for a correct preoperative diagnosis. An acurate preoperative diagnosis of NE carcinoma on FNAC can be achieved based on its distinctive cytomorphologic and immunocytochemical features. Diagn. Cytopathol. 2011;39:527-530. ' 2010 Wiley-Liss, Inc.Key Words: breast cancer; neuroendocrine tumor; cytology; plasmacytoid cells; immunocytochemistry Neuroendocrine (NE) tumors are derived from NE cells throughout the body and are generally rare. They mainly occur in the broncho-pulmonary system and gastro-intestinal tract.1 Primary NE carcinoma of the breast was recently recognized as a distinct entity and was added to the World Health Organization (WHO) classification of tumors (2003) under the category of NE tumors. The WHO defines them as mammary NE tumors as having morphological features similar to those of NE tumors from the gastrointestinal tract and lung, with expression of NE markers by more than 50% of the total cell population.2 NE tumors include solid NE carcinoma, atypical carcinoid tumors, small cell/oat cell carcinoma, and large cell NE carcinoma. Herein, we describe our experience with a case of a NE tumor (solid NE carcinoma) in the breast and discuss its cytopathologic features.
Case ReportA 67-year-old female was admitted to our hospital with a provisional diagnosis of a subareolar abscess in her right breast and bloody nipple discharge. Ultrasonography revealed irregular hypoechoic masses with a diameter of 0.8 3 0.7 cm in the outer quadrants of the right breast. Asymmetric breast tissue had been identified by mammography that was classified as Birads 3. Fine needle aspiration cytology (FNAC) and core needle biopsy were performed on a mass, with a diagnosis of malignancy.
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