Sidawy M K, Tabbara S O, Bryan J A, Poprocky L A, Frost A R
Department of Pathology, The George Washington University, Washington, DC, USA.
Cancer. 2001 Apr 25;93(2):140-5. doi: 10.1002/cncr.9020.
The reliability of cytologic criteria to classify nonproliferative breast lesions (NPBL) is still debated. Sampling error and heterogeneity of breast lesions complicates the histologic correlation of fine-needle aspiration results further.
To provide optimal cytohistologic correlation, two smears (one that was stained with hematoxylin and eosin and one that was stained with Diff-Quik [American Scientific Products, McGraw Park, IL]) were prepared from specific tissue sections from breast biopsies without mass lesions. The 42 cases classified as NPBL histologically were included in the current study. The cytologic features of the smears were evaluated.
Cellularity ranged from low (40% of cases) to moderate (50% of cases) to high (7% of cases). The cells were arranged in small clusters in 79% of cases, were mixed with large sheets in 17% of cases, and were in large sheets in 2% of cases. Intact lobules were noted in 31%. The configuration of the epithelial groups was complex in 62% of cases. Myoepithelial cells in the background and within the epithelial groups were noted in all the specimens. The percentage of single epithelial cells was < 10 in 38% of cases, 10-20 in 41%, and 20-30 in 19%. Mild nuclear enlargement and overlap, micronucleoli, and mild chromatin clumping were noted in a significant number of cases.
NPBL have been found to have a wide spectrum of cytologic appearances. At one end of the spectrum, smears are cellular with up to 30% single cells and large sheets in a complex configuration and exhibit nuclear enlargement and overlap and prominent nucleoli, features that overlap with those described in proliferative breast lesions.
用于对非增殖性乳腺病变（NPBL）进行分类的细胞学标准的可靠性仍存在争议。乳腺病变的取样误差和异质性使细针穿刺结果的组织学相关性进一步复杂化。
为提供最佳的细胞组织学相关性，从无肿块病变的乳腺活检组织切片制备两张涂片（一张用苏木精和伊红染色，另一张用Diff-Quik染色[美国科学产品公司，伊利诺伊州麦格劳公园]）。本研究纳入了42例组织学上分类为NPBL的病例。对涂片的细胞学特征进行评估。
细胞量从低（40%的病例）到中（50%的病例）至高（7%的病例）不等。79%的病例中细胞呈小簇状排列，17%的病例中细胞与大片状细胞混合，2%的病例中细胞呈大片状排列。31%的病例中可见完整的小叶。62%的病例中上皮细胞群的形态复杂。所有标本中均可见背景及上皮细胞群内的肌上皮细胞。38%的病例中单个上皮细胞的百分比<10%，41%的病例中为10%-20%，19%的病例中为20%-30%。在相当数量的病例中可见轻度核增大和重叠、微小核仁以及轻度染色质聚集。
已发现NPBL具有广泛的细胞学表现。在该表现谱的一端，涂片细胞丰富，有高达30%的单个细胞且呈复杂形态的大片状细胞，表现出核增大和重叠以及明显的核仁，这些特征与增殖性乳腺病变中描述的特征重叠。
