Cyrta J, Andreiuolo F, Azoulay S, Balleyguier C, Bourgier C, Mazouni C, Mathieu M-C, Delaloge S, Vielh P
Departments of Biology and PathologyRadiologyRadiotherapySurgeryMedicine, Institut de cancérologie Gustave Roussy, Villejuif, France.
Cytopathology. 2013 Dec;24(6):377-84. doi: 10.1111/cyt.12016. Epub 2012 Sep 21.
Mucinous (colloid) breast carcinoma accounts for 1-6% of all breast cancer. It comprises pure mucinous tumours and mixed infiltrating ductal carcinomas with a mucinous component. As this latter mixed form has a worse prognosis than pure colloid carcinoma, making this diagnosis on fine needle aspiration cytology (FNAC) might influence the choice of treatment.
We report a consecutive series of 22 cases consisting of 17 mixed and five pure mucinous carcinomas diagnosed by cytology and verified on histopathology. Patients underwent FNAC at the one-stop clinic of our institution during a 7-year period of time. Cytological findings were evaluated by a semi-quantitative method and included percentage of smear surface occupied by mucin, shape of cell groupings, size and outline of tumour nuclei as well as presence or absence of nucleolus.
Three of five pure mucinous carcinomas displayed at least two of the following features: abundant mucin, small nuclei and/or regular nuclear outlines. Sparse mucin, large nuclei, irregular nuclear outlines or the presence of nucleoli were found in 7 out of 17 mixed mucinous carcinomas but not in pure tumours.
Cytopathological identification of patients with pure mucinous carcinomas may be performed in a limited number of cases.
黏液性(胶样)乳腺癌占所有乳腺癌的1% - 6%。它包括纯黏液性肿瘤以及伴有黏液成分的混合性浸润性导管癌。由于后一种混合形式的预后比纯胶样癌更差,因此通过细针穿刺细胞学检查(FNAC)做出该诊断可能会影响治疗方案的选择。
我们报告了连续的22例病例,其中17例为混合性黏液癌,5例为纯黏液癌,均经细胞学诊断并经组织病理学证实。患者在我们机构的一站式门诊接受了为期7年的FNAC检查。通过半定量方法评估细胞学检查结果,包括涂片表面被黏液占据的百分比、细胞团的形状、肿瘤细胞核的大小和轮廓以及核仁的有无。
5例纯黏液癌中有3例表现出以下至少两种特征:黏液丰富、细胞核小和/或核轮廓规则。17例混合性黏液癌中有7例发现黏液稀少且细胞核大、核轮廓不规则或有核仁,但纯黏液癌中未发现这些情况。
在少数病例中可以对纯黏液癌患者进行细胞病理学鉴定。