Levine Pascale Hummel, Waisman Jerry, Yang Grace C H
Department of Pathology, New York University School of Medicine, New York, New York 10016-6497, USA.
Diagn Cytopathol. 2003 Jan;28(1):39-44. doi: 10.1002/dc.10209.
Cystic carcinomas of the breast are rarely encountered in fine-needle aspiration (FNA) biopsies. The most common entities comprise intracystic papillary adenocarcinoma, ductal adenocarcinoma with cystic degeneration including comedo forms of ductal adenocarcinoma in situ, medullary carcinoma, squamous carcinoma, and cystic hypersecretory ductal adenocarcinoma. The cytologic diagnosis is often hampered by sparse cellularity, abundant obscuring blood, necrotic debris, and degenerative changes in diagnostic cells. We report on the cytologic features of 10 cases of cystic carcinoma, including 12 FNA biopsies with radiologic and surgical correlation. The original cytologic diagnoses for these cases were: benign (2 cases), atypical (2 cases), suspicious (3 cases), and positive for malignant cells (3 cases). On repeat FNA, one benign case and one atypical case were reclassified, respectively, as atypical and suspicious for carcinoma. The follow-up diagnoses were 5 intracystic papillary adenocarcinomas and 5 cystic ductal adenocarcinomas. Despite 2 false-negative cases, all cases were adequately managed. Correlation with clinical and radiologic findings and direct sampling of any solid component of these cystic neoplasms are crucial in diagnosis and management.
乳腺囊性癌在细针穿刺（FNA）活检中很少见。最常见的类型包括囊内乳头状腺癌、伴有囊性退变的导管腺癌（包括原位导管腺癌的粉刺样类型）、髓样癌、鳞状癌以及囊性高分泌性导管腺癌。细胞诊断常常受到细胞数量稀少、大量血液干扰、坏死碎片以及诊断性细胞退变的影响。我们报告了10例囊性癌的细胞学特征，包括12例FNA活检，并与影像学和手术结果进行了对照。这些病例最初的细胞学诊断为：良性（2例）、非典型（2例）、可疑（3例）以及恶性细胞阳性（3例）。再次FNA时，1例良性病例和1例非典型病例分别重新分类为非典型和可疑癌。随访诊断为5例囊内乳头状腺癌和5例囊性导管腺癌。尽管有2例假阴性病例，但所有病例均得到了妥善处理。与临床和影像学检查结果相关，并对这些囊性肿瘤的任何实性成分进行直接采样，对于诊断和处理至关重要。
