Midulla C, Cenci M, De Iorio P, Amanti C, Vecchione A
Department of Experimental Medicine, University of Rome La Sapienza, Italy.
Anticancer Res. 1995 Nov-Dec;15(6B):2619-22.
In order to further characterize fine needle aspiration cytology of breast proliferative lesions, we analyzed 723 FNA of patients with palpable breast abnormalities who underwent physical, mammographic and/or echographic examination. In 28 biopsies (3.9%), the final cytologic diagnosis was a proliferative lesion, a group of uncommon breast proliferative diseases not yet explored, in which cytology is sufficiently cellular with plenty of atypical elements but not suspicious of carcinoma. Histologic material was available in 22 cases and represented the basis of this retrospective evaluation. Among the positive proliferative lesions (PPL), 10 cases were infiltrating ductal carcinomas and 1 was a microinvasive carcinoma; whereas for the negative proliferative lesions (NPL), in 8 cases the histologic findings demonstrated fibrocystic changes, in 1 a fibroadenoma and in 1 a cystosarcoma phyllodes. The cytologic criteria utilized to define breast proliferative lesions were the following: increased cellularity, occasional single atypical cells, decreased cellular cohesion, crowded, enlarged and overlapping nuclei with three dimensional groupings with prominent nucleoli and chromatic changes. The cytologic characteristics examined demonstrated that the PPL are characterized by single atypical cells with nuclear alterations such as coarsely granular chromatin with a thick nuclear membrane and numerous prominent nucleoli. These features are common to many malignancies, therefore surgical biopsy confirmation is suggested.
为了进一步明确乳腺增生性病变的细针穿刺细胞学特征，我们分析了723例接受体格检查、乳腺钼靶检查和/或超声检查的可触及乳腺异常患者的细针穿刺样本。在28例活检（3.9%）中，最终细胞学诊断为增生性病变，这是一组尚未研究的罕见乳腺增生性疾病，其细胞学表现为细胞丰富，有大量非典型细胞，但无癌可疑。22例有组织学材料，作为本次回顾性评估的基础。在阳性增生性病变（PPL）中，10例为浸润性导管癌，1例为微浸润癌；而在阴性增生性病变（NPL）中，8例组织学表现为纤维囊性变，1例为纤维腺瘤，1例为叶状囊肉瘤。用于定义乳腺增生性病变的细胞学标准如下：细胞增多、偶尔出现单个非典型细胞、细胞黏附性降低、细胞核拥挤、增大且重叠，呈三维聚集，核仁突出，有染色质改变。所检查的细胞学特征表明，PPL的特征是单个非典型细胞伴有核改变，如粗颗粒状染色质、厚核膜和众多突出的核仁。这些特征在许多恶性肿瘤中很常见，因此建议进行手术活检确诊。
