Theocharous C, Greenberg M L
Department of Hampson Pathology, Westmead, NSW, Australia.
Diagn Cytopathol. 1996 Dec;15(5):367-73. doi: 10.1002/(SICI)1097-0339(199612)15:5<367::AID-DC2>3.0.CO;2-9.
Fourteen cases of both palpable and non-palpable breast lesions reported as possible ductal carcinoma in situ (DCIS) on fine-needle biopsy (FNB) over a 12-mo period were retrieved from our files and compared to the subsequent histologic diagnosis. Although a definite cytologic pattern of highly cellular smears with high grade nuclei, dissociation, and background necrosis with microcalcifications emerged for comedo DCIS, it was not possible to differentiate these on cytologic grounds from high grade infiltrating carcinoma with necrosis unless mammographic findings were taken into account. Useful criteria for non-comedo low grade DCIS were high cellularity, low grade nuclei, and architectural features of papillary and three dimensional (3D) fragments, palisade arrangements, and monolayer sheets with punched out glandular lumina. We conclude that FNB has a definite role in the diagnosis of these lesions, with the limitation that invasive malignancy can never be excluded on cytologic criteria alone and clinico-radiological correlation is paramount.
在12个月期间，从我们的档案中检索出14例在细针穿刺活检（FNB）时报告为可能的导管原位癌（DCIS）的可触及和不可触及的乳腺病变病例，并与随后的组织学诊断结果进行比较。虽然粉刺型DCIS出现了一种明确的细胞学模式，即涂片细胞高度密集、核级别高、细胞解离以及伴有微钙化的背景坏死，但除非考虑乳腺钼靶检查结果，否则无法从细胞学上区分这些病变与伴有坏死的高级别浸润性癌。非粉刺型低级别DCIS的有用标准是细胞密集度高、核级别低以及乳头状和三维（3D）碎片、栅栏状排列和带有穿孔腺腔的单层细胞片的结构特征。我们得出结论，FNB在这些病变的诊断中具有明确作用，但局限性在于仅根据细胞学标准永远无法排除浸润性恶性肿瘤，临床-放射学相关性至关重要。
