Yeoh G P, Cheung P S, Chan K W
Histopathology Unit, Canossa Hospital, Hong Kong.
Am J Surg Pathol. 1999 May;23(5):552-9. doi: 10.1097/00000478-199905000-00009.
Mucocelelike tumors of the breast encompass a spectrum of pathologic lesions, including benign tumor, atypical ductal hyperplasia, carcinoma in situ, and colloid carcinoma. Because the fine-needle aspiration (FNA) cytology of mucocelelike tumors covering this pathologic spectrum is not well defined, a study of 21 cases of mucocelelike tumors was conducted. Benign lesions are likely to be poorly cellular and to contain cohesive clusters of cytologically bland cells arranged in two dimensional sheets in the background of abundant mucoid material. Colloid carcinomas are usually highly cellular and contain loosely cohesive clusters and dissociated cells with nuclei showing minimal to mild atypia. The most discriminating feature between benign and malignant lesions appears to be the presence of many dissociated cells with intact cytoplasm. Cases with atypical ductal hyperplasia, with some bordering on carcinoma in situ as seen in 7 of the 12 benign cases, may be difficult to identify on FNA cytology, possibly because of sampling. As expected, some of the atypical cases have intermediate features of benign and malignant tumors. Because of overlapping features in borderline cases, we recommend excisional biopsy for all mucocelelike lesions. Myxoid fibroadenoma is more cellular than benign mucocelelike lesions and can be distinguished from carcinoma by the absence of dissociation and presence of numerous bare nuclei of bland morphology in the background. The mucoid material of myxoid fibroadenoma stained brightly pink rather than magenta as in mucocelelike tumors using the Diff Quik stain.
乳腺黏液囊肿样肿瘤包括一系列病理病变，包括良性肿瘤、非典型导管增生、原位癌和黏液癌。由于涵盖这一病理谱的黏液囊肿样肿瘤的细针穿刺（FNA）细胞学特征尚未明确界定，因此对21例黏液囊肿样肿瘤进行了研究。良性病变的细胞数量可能较少，在大量黏液样物质背景下含有呈二维片状排列的细胞形态温和的细胞黏附性团块。黏液癌通常细胞丰富，含有松散黏附的团块和散在细胞，细胞核显示轻度至中度异型性。良性和恶性病变之间最具鉴别性的特征似乎是存在许多胞质完整的散在细胞。非典型导管增生的病例，如12例良性病例中的7例可见一些接近原位癌的情况，在FNA细胞学上可能难以识别，这可能是由于取材原因。正如预期的那样，一些非典型病例具有良性和恶性肿瘤的中间特征。由于临界病例存在重叠特征，我们建议对所有黏液囊肿样病变进行切除活检。黏液样纤维腺瘤比良性黏液囊肿样病变细胞更多，可通过不存在细胞解离以及背景中存在大量形态温和的裸核来与癌相鉴别。使用Diff Quik染色时，黏液样纤维腺瘤的黏液样物质染成亮粉色，而不像黏液囊肿样肿瘤那样染成品红色。
