Fine Needle Aspiration Cytology of Ductal Breast Carcinoma with Neuroendocrine Differentiation

Ng, Wai-Kuen; Poon, Cycles Suet-Ping; Kong, James

doi:10.1159/000326729

Cited by 20 publications

(21 citation statements)

References 12 publications

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“…In particular, in the monotonous type, 17 of 28 cases exhibited neuroendocrine differentiation. This result confirmed our previous report and other studies [5,8,9,10,11]. Additionally, in the 19 cases of neuroendocrine differentiation, 15 were positive for E-cadherin immunohistochemically, which is different from lobular carcinoma [12,13].…”

Section: Discussionsupporting

confidence: 91%

Loss of Cellular Cohesion in Cytology Composes a Special Subgroup of Breast Tumors - Analysis of 37 Cases

Wakasa

Nakamura²,

Kagiya

et al. 2013

Acta Cytologica

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Objective: We analyzed smears by fine needle aspiration (FNA) from 37 cases that displayed numerous dissociated cells and correlated the results with histological findings. Study Design: Between 1996 and 2005, 1,583 patients underwent breast FNA and resection. Loss of cellular cohesion was observed in 37 of these cases. Results: From the cytological findings, we classified cases into 3 groups according to cell size and shape. Type A: numerous isolated spindle cells with a necrotic background. Four cases were classified into this group (3 cases of intraductal papilloma and 1 case of adenomyoepithelioma). Type B: lymphocytes and large isolated cells such as medullary carcinoma. Five cases were classified into this group [1 case of classic medullary carcinoma, 1 case of ductal carcinoma in situ (DCIS) and 3 cases of invasive carcinoma of no special type (NST)]. Type C: numerous uniform small round cells. Twenty-eight cases were classified into this group (2 cases of lobular carcinoma, 1 case of DCIS, 22 cases of invasive carcinoma NST, and 3 cases of solid papillary carcinoma). Conclusion: Numerous isolated cells are sometimes seen in both benign and malignant cytology.

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Section: Discussionsupporting

confidence: 91%

Loss of Cellular Cohesion in Cytology Composes a Special Subgroup of Breast Tumors - Analysis of 37 Cases

Wakasa

Nakamura²,

Kagiya

et al. 2013

Acta Cytologica

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“…It is characterized by cellular monotony, nuclear palisading, pseudorosette formation, loss of cell cohesion, and abundant eosinophilic cytoplasm and nuclei with stippled (‘salt and pepper’) chromatin [49,57-59]. Nevertheless these features per se are not sensitive enough to rule in a diagnosis because they are inconsistently present [57].…”

Section: Discussionmentioning

confidence: 99%

Locally-advanced primary neuroendocrine carcinoma of the breast: case report and review of the literature

et al. 2013

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BackgroundPrimary neuroendocrine carcinoma of the breast is a heterogeneous group of rare tumors with positive immunoreactivity to neuroendocrine markers in at least 50% of cells. Diagnosis also requires that other primary sites be ruled out and that the same tumor show histological evidence of a breast in situ component. Primary neuroendocrine carcinoma of the breast rarely presents as locally advanced disease and less frequently with such widespread metastatic disease as described herein. The review accompanying this case report is the first to provide an overview of all the cases of primary neuroendocrine carcinoma of the breast published in the literature and encompasses detailed information regarding epidemiology, histogenesis, clinical and histologic diagnosis criteria, classification, surgical and adjuvant treatment, as well as prognosis. We also provide recommendations for common clinical and histologic pitfalls associated with this tumor.Case presentationWe describe a case of a 51-year-old Hispanic woman initially diagnosed with locally-advanced invasive ductal carcinoma that did not respond to neodjuvant treatment. After undergoing modified radical mastectomy the final surgical pathology showed evidence of alveolar-type primary neuroendocrine carcinoma of the breast. The patient was treated with cisplatin/etoposide followed by paclitaxel/carboplatinum. Thirteen months after surgery the patient is alive, but developed pulmonary, bone, and hepatic metastasis.ConclusionThe breast in situ component of primary neuroendocrine carcinoma of the breast may prevail on a core biopsy samples increasing the probability of underdiagnosing this tumor preoperatively. Being aware of the existence of this disease allows for timely diagnosis and management. Optimal treatment requires simultaneous consideration of both the neuroendocrine and breast in situ tumor features.

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“…With regard to the cytologic differential diagnosis, this entity must be distinguished from other subtypes of mucinous carcinoma, invasive micropapillary carcinoma, micropapillary/cystic hypersecretory DCIS, other mucocele‐like lesions, and even myxoid fibroadenoma. In contrast to the micropapillary variant, the neuroendocrine subtype of mucinous carcinoma tends to yield loosely dispersed tumor cells on fine‐needle aspiration biopsies 27, 28. The tumor cells show neuroendocrine cytology, including stippled chromatin, a plasmacytoid appearance, and granular eosinophilic cytoplasm.…”

Section: Discussionmentioning

confidence: 99%

Fine-needle aspiration cytology findings of an uncommon micropapillary variant of pure mucinous carcinoma of the breast

2002

Cancer

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BACKGROUND Previous attempts at subclassifying pure mucinous carcinomas of the breast based on architectural patterns and other associated features are on record. A distinctive micropapillary variant with most tumor cells arranged in micropapillae/pseudoacini has not been described previously. METHODS The author reviewed the histologic slides from all 556 patients who underwent wide excision/mastectomy for mammary ductal carcinoma, either in situ or invasive, at Pamela Youde Nethersole Eastern Hospital, Hong Kong, during an 8‐year period from early 1994 to the end of 2001. Five patients with pure mucinous carcinoma with diffuse micropapillary architecture were noted. The cytologic features (if available) were correlated with clinical, radiologic, and pathologic findings. RESULTS Among the five patients with pure mammary mucinous carcinoma (micropapillary variant), three patients underwent preoperative fine‐needle aspiration biopsies and had specimens available for review. The direct smears and cytospin preparations were of moderate cellularity and showed cohesive clusters and micropapillae of mildly pleomorphic tumor cells among a mucoid background. True tumor papillae with fibrovascular cores were not present. Nuclear hobnailing was observed commonly, and occasional psammoma bodies were found. There were also scanty isolated tumor cells scattered around. The pseudoacinar pattern was appreciated more readily in the cell block sections. Histologic examination of the surgical specimens showed features of pure mucinous carcinoma with diffuse micropapillary architecture. The micropapillary arrangement was confirmed further by the demonstration of a reverse polarity immunostaining pattern for epithelial membrane antigen and the identification of microvilli rimming the periphery of tumor cell clusters under the electron microscope. Peritumoral lymphovascular permeation and ipsilateral axillary lymph node metastasis was found in one of the patients. CONCLUSIONS The micropapillary variant of mammary mucinous carcinoma demonstrates characteristic cytologic and histologic features that warrant special attention. It may represent the mucinous counterpart of invasive micropapillary carcinoma. Further analysis of a larger series of patients, however, will be required to delineate its prognostic significance, especially its propensity for lymph node metastasis. Cancer (Cancer Cytopathol) 2002;96:280–8. © 2002 American Cancer Society.

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Fine Needle Aspiration Cytology of Ductal Breast Carcinoma with Neuroendocrine Differentiation

Cited by 20 publications

References 12 publications

Loss of Cellular Cohesion in Cytology Composes a Special Subgroup of Breast Tumors - Analysis of 37 Cases

Loss of Cellular Cohesion in Cytology Composes a Special Subgroup of Breast Tumors - Analysis of 37 Cases

Locally-advanced primary neuroendocrine carcinoma of the breast: case report and review of the literature

Fine-needle aspiration cytology findings of an uncommon micropapillary variant of pure mucinous carcinoma of the breast

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