Fulciniti Franco, Mansueto Gelsomina, Vetrani Antonio, Accurso Antonello, Fortunato Adriana, Palombini Lucio
Dipartimento di Scienze Biomorfologiche e Funzionali, Sezione di Citopatologia, Naples, Italy.
Diagn Cytopathol. 2005 Sep;33(3):205-9. doi: 10.1002/dc.20340.
Metaplastic breast carcinoma (MBC) may have a varied presentation on fine-needle cytology samples. We herewith describe three cases of MBC found in our series. One of these cases showed a peculiar mixture of malignant ductal, apocrine type, and squamous epithelial cells with fascicles of spindle cells with variable degree of atypia and was diagnosed as metaplastic carcinoma of the carcino-sarcomatous type. The other two lesions were characterized by an abundant chondroid extracellular matrix to which were variably admixed carcinomatous and chondroid-type cells, with variable degree of atypia. Both these latter cases were defined as matrix-producing metaplastic carcinomas. Because of the various presentation of MBC on fine-needle cytology samples and the possible influence of needle "sampling" on the cytological specimen, the spectrum of differential diagnoses to be considered may encompass a number of benign and malignant entities, like keratinous subareolar cysts, malignant fibroepithelial lesions with myxo-chondroid stroma, and true sarcomas of the breast, with cartilaginous metaplasia. It is the Authors' feeling that, with optimal samples, the cytomorphological findings of this rare variant of breast carcinoma permit its accurate pre-operative diagnosis.
化生性乳腺癌（MBC）在细针穿刺细胞学样本中可能有多种表现。我们在此描述我们系列中发现的3例MBC病例。其中1例显示恶性导管、大汗腺型和鳞状上皮细胞与不同程度异型性的梭形细胞束奇特混合，被诊断为癌肉瘤型化生性癌。另外2个病变的特征是有丰富的软骨样细胞外基质，其中不同程度地混合有癌性和软骨样细胞，且有不同程度的异型性。后2例均被定义为产生基质的化生性癌。由于MBC在细针穿刺细胞学样本中有多种表现，且针吸“采样”可能对细胞学标本产生影响，需要考虑的鉴别诊断范围可能包括许多良性和恶性病变，如乳晕下角质囊肿、伴有黏液软骨样间质的恶性纤维上皮性病变以及伴有软骨化生的乳腺真性肉瘤。作者认为，在样本理想的情况下，这种罕见的乳腺癌变异型的细胞形态学表现有助于其准确的术前诊断。
