Robinson I A, McKee G, Jackson P A, Cook M G, Kissin M W
Department of Cytopathology, Royal Surrey County Hospital, Guildford, UK.
Diagn Cytopathol. 1995 Oct;13(3):196-201. doi: 10.1002/dc.2840130304.
Lobular carcinomas have a distinct natural history with a better response to endocrine therapy and a higher incidence of local recurrence and are more often bilateral. The cytological diagnosis of lobular carcinoma permits a discriminating therapeutic approach with pre-operative Tamoxifen, more generous resection margins, and assessment of the contralateral breast. The cytological features of lobular cancer however are not well defined and the low cell yield from such neoplasms can result in a high false negative rate. To determine whether we could improve the pre-operative diagnosis, we reviewed the cytological features of 112 lobular carcinomas. They had small uniform sized nuclei with irregular outlines and inconspicuous nucleoli. The degree of dissociation was similar to duct carcinomas and the incidence of inadequate aspirates was no higher. We found no features that confidently diagnosed lobular cancer or its sub-types. However, using a combination of features, typing of lobular cancer on aspirated material is possible and should be attempted.
小叶癌具有独特的自然病史，对内分泌治疗反应较好，但局部复发率较高，且更常为双侧性。小叶癌的细胞学诊断允许采用有区别的治疗方法，包括术前使用他莫昔芬、更广泛的切除边缘以及对侧乳房评估。然而，小叶癌的细胞学特征并不明确，此类肿瘤的低细胞产量可导致较高的假阴性率。为了确定我们是否能改善术前诊断，我们回顾了112例小叶癌的细胞学特征。它们具有大小均匀的小核，轮廓不规则，核仁不明显。解离程度与导管癌相似，抽吸不足的发生率也不高。我们未发现能可靠诊断小叶癌或其亚型的特征。然而，结合多种特征，对抽吸材料上的小叶癌进行分型是可能的，应该尝试。
