Mondal Krishnendu, Mandal Rupali
Department of Pathology, Sonoscan Healthcare, West Bengal, India.
Eur J Breast Health. 2021 Mar 31;17(2):103-111. doi: 10.4274/ejbh.galenos.2020.6154. eCollection 2021 Apr.
This study aimed to determine the cytodiagnostic spectrum of various male breast lesions, which were corroborated on histopathology as appropriate, to describe the process of the cytomorphology of some uncommon pathological lesions, and to discuss the reasons of their misdiagnoses.
In this 8-year study, a total of 114 patients underwent fine needle aspiration cytology (FNAC). In a representative case, nipple discharge from an 8-month-old child was examined. Confirmatory histopathology was obtained in 38 cases only.
Gynecomastia was the most common (63.5%) male breast pathology. Invasive breast carcinoma of no special type was the most common variant of male breast malignancy. Half of the "gray zone" of cytological lesions was confirmed as cancer, but the rest were diagnosed as fibrocystic disease and intraductal papilloma. All cases with malignant cytology matched their corresponding histopathology. However, a tumor from an intraductal papillary carcinoma was miscued as ductal carcinoma on previous FNAC.
Cytological evaluation of male breast lesions provides highly sensitive and specific results with excellent histologic reproducibility. Thus, it should be the ideal pretherapeutic diagnostic procedure for male breasts. However, some benign pathological conditions, which are particularly associated with epithelial hyperplasia, perplex the cytomorphologic scenario into the "gray zone."
本研究旨在确定各种男性乳腺病变的细胞诊断谱，并在适当情况下通过组织病理学予以证实，描述一些罕见病理病变的细胞形态学过程，并探讨其误诊原因。
在这项为期8年的研究中，共有114例患者接受了细针穿刺细胞学检查（FNAC）。在一个具有代表性的病例中，对一名8个月大婴儿的乳头溢液进行了检查。仅38例获得了确诊的组织病理学检查结果。
男性乳腺增生是最常见的（63.5%）男性乳腺病理情况。非特殊类型的浸润性乳腺癌是男性乳腺恶性肿瘤最常见的类型。细胞学病变的“灰色地带”中有一半被确诊为癌症，但其余的被诊断为纤维囊性疾病和导管内乳头状瘤。所有具有恶性细胞学特征的病例均与相应的组织病理学结果相符。然而，一例导管内乳头状癌的肿瘤在之前的FNAC检查中被误诊为导管癌。
男性乳腺病变的细胞学评估提供了高度敏感和特异的结果，具有出色的组织学可重复性。因此，它应该是男性乳腺理想的治疗前诊断方法。然而，一些与上皮增生特别相关的良性病理状况，使细胞形态学情况陷入“灰色地带”。
