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男性出现血性乳头溢液(伴或不伴乳房肿块)的细胞学评估:两例病例报告描绘疾病谱的两个极端情况

Cytological evaluation in males presenting with bloody nipple discharge, with or without breast mass: Report of two cases depicting two poles of the disease spectrum.

作者信息

Sood Neelam

机构信息

Department of Pathology and Lab Medicine, Deen Dayal Upadhyay Hospital, Government of NCT, Delhi, New Delhi, India.

出版信息

Diagn Cytopathol. 2019 Feb;47(2):121-126. doi: 10.1002/dc.24080. Epub 2018 Oct 24.

Abstract

Nipple discharge (ND) either in the presence or in the absence of underlying mass is a very uncommon presentation in males and its bloody nature is still rarer. ND cytology in males has not been reported much in the literature. Spontaneous and expressed ND, however, can be very useful in establishing the diagnosis. Two males with bloody ND, one, without any palpable mass and another with underlying mass, were evaluated on ND cytology. The presence of loose papillaroid clusters and cell sheets with mild atypia was seen in ND smears itself in case 1. The discharge was more copious in case 2, but the ND smears were paucicellular. The presence of tall columnar cells in ND smears as well as in the FNA from underlying mass with clear features of malignancy was helpful in reaching the diagnosis of papillary carcinoma in case 2. Histopathology in case 1 was a spectrum of ADH to DCIS, whereas in case 2, was tubulopapillary carcinoma. Following two cases highlight the importance of the cytological evaluation of ND smears.

摘要

乳头溢液(ND)无论有无潜在肿块,在男性中都是非常罕见的表现,而血性乳头溢液则更为罕见。男性乳头溢液的细胞学检查在文献中报道不多。然而,自发性和挤压性乳头溢液在确立诊断方面可能非常有用。对两名有血性乳头溢液的男性进行了乳头溢液细胞学评估,其中一名没有可触及的肿块,另一名有潜在肿块。病例1的乳头溢液涂片本身可见松散的乳头样细胞簇和轻度异型性的细胞片。病例2的溢液量更多,但乳头溢液涂片细胞数量少。病例2的乳头溢液涂片以及来自潜在肿块的细针穿刺抽吸物中存在具有明显恶性特征的高柱状细胞,有助于诊断为乳头状癌。病例1的组织病理学表现为从非典型导管增生到导管原位癌的一系列病变,而病例2为微管乳头状癌。以下两个病例突出了乳头溢液涂片细胞学评估的重要性。

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