Venegas R, Rutgers J L, Cameron B L, Vargas H, Butler J A
Department of Pathology, Harbor-University of California, Torrance 90509.
Acta Cytol. 1994 Mar-Apr;38(2):136-43.
To evaluate the role of fine needle aspiration cytology (FNAC) in identifying in situ breast carcinoma, we reviewed 19 FNACs of histologically confirmed pure or predominantly ductal carcinoma in situ (DCIS). The cytologic diagnosis was positive for malignancy in 53%, suspicious in 31% and nondiagnostic in 16%. An intraductal lesion was suggested prospectively in 21%. Retrospective review showed three distinctive cytologic criteria in cases with DCIS: (1) cohesive groups of atypical ductal cells associated with scattered, individual malignant cells or a necrotic background; (2) hyperplastic ductal cells with associated malignant cells or necrosis; and (3) true tissue fragments composed of cohesive epithelial cells with a cribriform pattern. One or more findings were present in 81% of the malignant or suspicious FNACs; 19% could not be distinguished cytologically from invasive carcinoma. We studied a control group of 30 invasive ductal carcinomas; one or more criteria were found in 35% of cases with no or a minor DCIS component but in 73% of those with an extensive DCIS component. We conclude that these three criteria deserve further study as an aid in suggesting DCIS on FNAC.
为评估细针穿刺细胞学检查（FNAC）在识别乳腺原位癌中的作用，我们回顾了19例经组织学证实为纯或主要为导管原位癌（DCIS）的FNAC病例。细胞学诊断为恶性的占53%，可疑的占31%，无法诊断的占16%。前瞻性提示导管内病变的占21%。回顾性分析显示DCIS病例有三个独特的细胞学标准：（1）非典型导管细胞的黏附性细胞团，伴有散在的单个恶性细胞或坏死背景；（2）增生性导管细胞伴有相关恶性细胞或坏死；（3）由具有筛状结构的黏附上皮细胞组成的真正组织碎片。81%的恶性或可疑FNAC病例存在一项或多项表现；19%在细胞学上无法与浸润性癌区分。我们研究了一个由30例浸润性导管癌组成的对照组；在无或有少量DCIS成分的病例中，35%发现一项或多项标准，而在有广泛DCIS成分的病例中，73%发现一项或多项标准。我们得出结论，这三个标准值得进一步研究，以辅助在FNAC中提示DCIS。
