Columnar cell lesions: Fine‐needle aspiration biopsy features

Saqi, Anjali; Mazziotta, Robert; Hamele‐Bena, Diane

doi:10.1002/dc.20158

Cited by 11 publications

(5 citation statements)

References 14 publications

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“…A highly cellular FNA smear with cytologic atypia derived from such an area in a radiologically suspicious lesion can be misinterpreted as malignant. 33,34 It is defined as columnar cells lining dilated terminal ducts of lobular units, showing a spectrum of hyperplasia and cytologic atypia merging with ADH and DCIS. These components can closely mimic low-grade tubular carcinoma both cytologically and histologically.…”

Section: Fibroadenomamentioning

confidence: 99%

Fine Needle Biopsy Cytology of Breast Lesions

Orell¹,

Miliauskas²

2005

Advances in Anatomic Pathology

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Screening mammography and greater community awareness of breast carcinoma have led to an increase in fine needle biopsies of the breast. As a consequence, a wide variety of cytologic patterns have been encountered and studied in benign, proliferative, and malignant breast lesions. We review the main reasons for diagnostic difficulties in breast cytology, the situations in which either a false positive or a false negative diagnosis is possible, as well as conditions whose incorrect typing can lead to inappropriate management.

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Section: Fibroadenomamentioning

confidence: 99%

Fine Needle Biopsy Cytology of Breast Lesions

Orell¹,

Miliauskas²

2005

Advances in Anatomic Pathology

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“…Saqi et al describe CCLs of the breast as being characterized cytologically by enlarged nuclei, cohesive three-dimensional cell groups with overlapping cells, palisading columnar cells, and occasional apocrine snouts. 12 Of note, 12 of the 20 cases reviewed by Saqi et al showed a coexisting lesion (eight fibroadenomas and four proliferative lesions), which can complicate the cytologic features seen in these cases.…”

Section: Discussionmentioning

confidence: 92%

Cytologic diagnosis of columnar‐cell lesions of the breast

Jensen

Kong

2007

Diagnostic Cytopathology

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This study describes the cytologic features of breast columnar-cell lesions (CCLs) and determines whether these lesions can be diagnosed by fine-needle aspiration. We present ten cases of biopsy-proven CCL with prior fine-needle aspiration material and discuss the spectrum of changes, as well as features important in the cytologic distinction of CCL from diagnostic mimics. CCLs were characterized by flat sheets of cells with enlarged nuclei, distinct cell borders, and finely granular cytoplasm. Cytologic atypia ranged from minimal to severe, and many cases (8/10) exhibited a paucity of myoepithelial cells. CCL showed significant cytologic overlap with papillary neoplasms and well-differentiated adenocarcinomas. The prospective diagnosis of CCL cannot reliably be made by fine-needle aspiration. However, it is important to recognize the range of cytologic atypia that can be seen with CCL to avoid an overdiagnosis of malignancy.

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“…Nevertheless, they have been described in several small cohorts. In a series of 20 fine needle aspirations (FNAs) with subsequent histologic diagnoses of CCLs, Saqi et al described three-dimensional groups with overlapping cells, palisading columnar cells and occasional apocrine snouts [ 69 ]. Although 18 of 20 FNAs were described as atypical, only five of the cases demonstrated cytologic atypia on subsequent CNB.…”

Section: Cytologic Featuresmentioning

confidence: 99%

Are Columnar Cell Lesions the Earliest Non-Obligate Precursor in the Low-Grade Breast Neoplasia Pathway?

Strickland

Turashvili

2022

Current Oncology

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Columnar cell lesions (CCLs) of the breast comprise a spectrum of morphologic alterations of the terminal duct lobular unit involving variably dilated and enlarged acini lined by columnar epithelial cells. The World Health Organization currently classifies CCLs without atypia as columnar cell change (CCC) and columnar cell hyperplasia (CCH), whereas flat epithelial atypia (FEA) is a unifying term encompassing both CCC and CCH with cytologic atypia. CCLs have been increasingly recognized in stereotactic core needle biopsies (CNBs) performed for the assessment of calcifications. CCLs are believed to represent the earliest non-obligate precursor of low-grade invasive breast carcinomas as they share molecular alterations and often coexist with entities in the low-grade breast neoplasia pathway. Despite this association, however, the risk of progression of CCLs to invasive breast carcinoma appears low and may not exceed that of concurrent proliferative lesions. As the reported upgrade rates of pure CCL/FEA when identified as the most advanced high-risk lesion on CNB vary widely, the management of FEA diagnosed on CNB remains controversial. This review will include a historical overview of CCLs and will examine histologic diagnostic criteria, molecular alterations, prognosis and issues related to upgrade rates and clinical management.

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Columnar cell lesions: Fine‐needle aspiration biopsy features

Cited by 11 publications

References 14 publications

Fine Needle Biopsy Cytology of Breast Lesions

Fine Needle Biopsy Cytology of Breast Lesions

Cytologic diagnosis of columnar‐cell lesions of the breast

Are Columnar Cell Lesions the Earliest Non-Obligate Precursor in the Low-Grade Breast Neoplasia Pathway?

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