de la Torre M, Lindholm K, Lindgren A
Department of Pathology, Uppsala University Hospital.
Acta Cytol. 1994 Nov-Dec;38(6):884-90.
Fine needle aspiration cytology (FNAC) findings in 33 tubular breast carcinomas (TC) and 10 radial scars (RS) were reviewed. In 19 (57%) cases of TC, a categorical diagnosis of malignancy could be made. Four (12%) TC, all containing myoepithelial cells, were misdiagnosed as benign. None of the RS was misinterpreted as malignant on FNAC. All RS smears contained myoepithelial cells. Although RS shared some of the cytologic features of TC, the lack of conspicuous nucleoli and pleomorphism prevented a false-positive diagnosis. Tubular angular structures, considered to be a characteristic feature of TC, may also occur in RS. Cellularity was poorer in RS than TC. The FNA yield obtained when attempting to aspirate small TC and RS lesions may originate in adjacent breast lesions and give a misleading cytologic picture. The occurrence of myoepithelial cells and/or lack of dissociation are not unequivocal benign signs in FNA smears; such findings do occur in TC. Finally, the difficulties that may be encountered in the diagnosis of TC and RS by frozen section are briefly discussed. Radiology often helped in establishing a diagnosis of malignancy in TC but did not help in ruling out malignancy in RS. A teamwork approach to the diagnosis and management of these lesions is recommended.
回顾了33例管状乳腺癌（TC）和10例放射状瘢痕（RS）的细针穿刺细胞学（FNAC）检查结果。在19例（57%）TC病例中，可以做出恶性肿瘤的明确诊断。4例（12%）TC均含有肌上皮细胞，被误诊为良性。FNAC检查中没有一例RS被误诊为恶性。所有RS涂片均含有肌上皮细胞。虽然RS与TC有一些细胞学特征相同，但缺乏明显的核仁和多形性可避免假阳性诊断。管状角状结构被认为是TC的特征性表现，也可能出现在RS中。RS的细胞密度比TC低。在试图抽吸小的TC和RS病变时获得的FNA标本可能来源于相邻的乳腺病变，并给出误导性的细胞学图像。在FNA涂片中，肌上皮细胞的出现和/或细胞未解离并非明确的良性征象；此类表现确实会出现在TC中。最后，简要讨论了通过冰冻切片诊断TC和RS时可能遇到的困难。放射学检查通常有助于确立TC的恶性诊断，但对排除RS的恶性诊断没有帮助。建议采用团队协作的方法对这些病变进行诊断和管理。
