Gomez-Aracil V, Mayayo E, Azua J, Arraiza A
Departamento de Patologia, Universidad de Zaragoza, Spain.
Cytopathology. 2002 Feb;13(1):22-30. doi: 10.1046/j.1365-2303.2002.00352.x.
Papillary neoplasms of the breast include a wide spectrum of mammary lesions. The differential diagnosis of benign and malignant lesions can be problematic not only cytologically, but also histopathologically. Aspiration smears can demonstrate that cytological differentiation is feasible. A retrospective study of 30 cases of papillary tumour of the breast, 15 papillary carcinomas and 15 papillomas, was performed to find the cytological differences between the pathologies. Cytological samples of papillary carcinomas were characterized by an abundance of cellular material, three-dimensional papillary clusters without fibrovascular connective tissue cores, small papillae arranged in cell balls, tall columnar cells and isolated naked nuclei. Numerous haemosiderin-laden macrophages were seen. There were no eosinophilic bipolar cytoplasmic granules, bipolar naked nuclei or apocrine metaplasia. In the papillomas there was less material; the papillae had cohesive stalks surrounded by columnar cells in a honeycomb pattern. We also found fewer small papillae and isolated columnar cells. In addition, the presence of apocrine metaplasia and bipolar naked nuclei was noted. We suggest that papillary carcinoma of the breast can be diagnosed by cytology and differentiated from papilloma.
乳腺乳头状肿瘤包括一系列广泛的乳腺病变。良性和恶性病变的鉴别诊断不仅在细胞学上存在问题，在组织病理学上也可能存在困难。细针穿刺涂片可以证明细胞学鉴别是可行的。对30例乳腺乳头状肿瘤（15例乳头状癌和15例乳头状瘤）进行了回顾性研究，以找出不同病理类型之间的细胞学差异。乳头状癌的细胞学样本具有以下特征：细胞丰富，三维乳头状簇无纤维血管结缔组织核心，小乳头排列成细胞球，高柱状细胞和孤立的裸核。可见大量含铁血黄素巨噬细胞。未见嗜酸性双极细胞质颗粒、双极裸核或大汗腺化生。乳头状瘤的细胞物质较少；乳头有粘性的茎，被柱状细胞以蜂窝状围绕。我们还发现小乳头和孤立的柱状细胞较少。此外，还注意到存在大汗腺化生和双极裸核。我们认为乳腺乳头状癌可以通过细胞学诊断，并与乳头状瘤相鉴别。
