Prathiba D, Rao Shalinee, Kshitija Kasthuri, Joseph Leena Dennis
Department of Pathology, Sri Ramachandra University, Chennai, India.
J Cytol. 2010 Jan;27(1):12-5. doi: 10.4103/0970-9371.66692.
True papillary lesions of the breast have a significantly high error rate on fine needle aspiration cytology (FNAC), as many other nonpapillary breast lesions exhibit overlapping features on cytosmears.
To evaluate the utility of individual morphological features in offering a more precise cytodiagnosis in papillary lesions of the breast.
Cytology smears reported as papillary lesions on nipple discharge / FNAC and histopathology over a period of two years were studied and correlated. A subjective assessment of morphological features, namely, the cellular yield, presence of three-dimensional papillary clusters, stromal bare nuclei, presence of cyst macrophages and cellular atypia was carried out on cytosmears.
Fourteen cases of papillary lesions were identified. Thirty-six per cent of the cases were found to be true positive, 43% false negative and 21% false positive with a sensitivity of 42% for papillary lesions. Eight of nine papillary lesions showed cyst macrophages. Stromal bare nuclei were seen in three of four malignant papillary lesions. However, the number of stromal bare nuclei was less compared to benign lesions. None of the malignant nonpapillary lesions showed stromal bare nuclei.
Cytomorphological features alone are inadequate for the precise diagnosis of papillary lesions of the breast.
乳腺真性乳头状病变在细针穿刺细胞学检查（FNAC）中的误诊率显著较高，因为许多其他非乳头状乳腺病变在细胞涂片上表现出重叠特征。
评估个体形态学特征在乳腺乳头状病变更精确细胞诊断中的作用。
研究并对比了两年期间乳头溢液/FNAC报告为乳头状病变的细胞学涂片及组织病理学检查结果。对细胞涂片上的形态学特征进行主观评估，即细胞产量、三维乳头状簇的存在、间质裸核、囊肿巨噬细胞的存在及细胞异型性。
共鉴定出14例乳头状病变。36%的病例为真阳性，43%为假阴性，21%为假阳性，乳头状病变的敏感性为42%。9例乳头状病变中有8例可见囊肿巨噬细胞。4例恶性乳头状病变中有3例可见间质裸核。然而，与良性病变相比，间质裸核数量较少。恶性非乳头状病变均未见间质裸核。
仅依靠细胞形态学特征不足以精确诊断乳腺乳头状病变。
