Peterse J L, Thunnissen F B, van Heerde P
Department of Cytology and Pathology, Netherlands Cancer Institute, Amsterdam.
Acta Cytol. 1989 Mar-Apr;33(2):176-80.
The range of radiation-induced changes in fine needle aspiration (FNA) smears of the breast is described. In 41 of more than 800 patients who underwent breast-conserving treatment, a palpable breast lesion developed, and FNA was performed. In six cases, a recurrent carcinoma was present. In the remaining cases, three patterns of nonneoplastic lesions could be discerned: epithelial atypia (14 cases), fat necrosis (10 cases) and poorly cellular smears without epithelial atypia or fat necrosis (13 cases). It is important to be familiar with the patterns of radiation-induced epithelial atypia, since such atypia may lead to a misdiagnosis of recurrent carcinoma. These atypical cells may show impressive anisocytosis and anisonucleosis; however, the nuclear/cytoplasmic ratio remains normal and an admixture of bipolar cells is present. Cell dissociation and necrotic cell debris, as often seen in breast cancer smears, were never encountered in FNA smears from radiated nonneoplastic breasts.
本文描述了乳腺细针穿刺（FNA）涂片辐射诱导变化的范围。在800多名接受保乳治疗的患者中，有41例出现了可触及的乳腺病变，并进行了FNA检查。其中6例存在复发性癌。在其余病例中，可以识别出三种非肿瘤性病变模式：上皮异型增生（14例）、脂肪坏死（10例）和无上皮异型增生或脂肪坏死的细胞涂片稀少（13例）。熟悉辐射诱导的上皮异型增生模式很重要，因为这种异型增生可能导致复发性癌的误诊。这些非典型细胞可能表现出明显的细胞大小不均和核大小不均；然而，核质比仍保持正常，且存在双极细胞混合。辐射诱导的非肿瘤性乳腺FNA涂片从未出现过乳腺癌涂片常见的细胞解离和坏死细胞碎片。
