Guzelbey Burcu, Hacihasanoglu Ezgi, Talu Canan Kelten, Cakir Yasemin, Nazli Mehmet A
Department of Pathology, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Department of Pathology, Yeditepe University School of Medicine, Istanbul, Turkey.
J Cytol. 2021 Oct-Dec;38(4):216-224. doi: 10.4103/JOC.JOC_56_21. Epub 2021 Nov 22.
This study aimed to describe the cytological features of neuroendocrine breast tumors and to show the effect of the extent of neuroendocrine differentiation on cytological features.
Breast tumor excision materials showing immunostaining with neuroendocrine markers (Synaptophysin or Chromogranin A) were determined and divided into two groups: cases with focal (10%-50% of tumor cells) staining and cases with diffuse (>50% of tumor cells) staining. A group of cases without neuroendocrine features/staining was used as control group. Fine needle aspiration biopsy specimens of the tumor mass or metastatic lymph nodes were examined and compared.
Twenty cases with neuroendocrine differentiation were included. Eleven cases were in the diffuse group, nine cases were in the focal group. Clean background, high cellularity, loosely cohesive cell groups with monotonous appearance, and naked nuclei were more common in the diffuse group. On the contrary, tight cohesive cell groups, the proportion of large cells, nuclear pleomorphism, and nucleolar prominence were higher in the group with focal staining. Plasmocytoid appearance, isolated cell groups, and binucleation were in similar distribution in both groups. Although round-oval nuclei were dominant in both groups, round nuclei were observed to be slightly more in the diffuse group. Only two cases in diffuse group showed cytoplasmic granularity and one case in focal group showed necrosis and mitosis. In the control group, tight cohesive groups, large cell size, pleomorphism, prominent nucleoli, and coarse chromatin were more commonly encountered.
Clean background, hypercellularity, loss of cohesion, naked nuclei, monotonous cells with round nucleus, and granular cytoplasm were more prominent in cases showing diffuse staining with neuroendocrine markers. Suspecting neuroendocrine differentiation in tumors that show focal staining with neuroendocrine markers can be challenging in cytological preparations.
本研究旨在描述神经内分泌性乳腺肿瘤的细胞学特征，并展示神经内分泌分化程度对细胞学特征的影响。
确定显示神经内分泌标志物（突触素或嗜铬粒蛋白A）免疫染色的乳腺肿瘤切除材料，并分为两组：局灶性染色（肿瘤细胞的10%-50%）病例和弥漫性染色（肿瘤细胞的>50%）病例。一组无神经内分泌特征/染色的病例用作对照组。对肿瘤块或转移性淋巴结的细针穿刺活检标本进行检查并比较。
纳入20例具有神经内分泌分化的病例。弥漫性组11例，局灶性组9例。弥漫性组更常见背景干净、细胞丰富、细胞团松散黏附且外观单一以及裸核。相反，局灶性染色组紧密黏附的细胞团、大细胞比例、核多形性和核仁突出更明显。浆细胞样外观、孤立细胞团和双核在两组中的分布相似。虽然两组均以圆形-椭圆形核为主，但弥漫性组圆形核略多。弥漫性组仅2例显示细胞质颗粒，局灶性组1例显示坏死和有丝分裂。对照组更常见紧密黏附的细胞团、大细胞大小、多形性、突出的核仁和粗糙的染色质。
在显示神经内分泌标志物弥漫性染色的病例中，背景干净、细胞增多、黏附丧失、裸核、圆形核的单一细胞以及颗粒状细胞质更为突出。在细胞学制片中，怀疑神经内分泌标志物局灶性染色的肿瘤存在神经内分泌分化可能具有挑战性。
