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Aggressive papillary male breast carcinoma on fine‐needle cytology sample
Author(s) -
Zeppa Pio,
Mascolo Massimo,
Zabatta Assunta,
Finelli Luigi,
Vetrani Antonio,
Palombini Lucio
Publication year - 2003
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.10398
Subject(s) - pathology , medicine , papanicolaou stain , breast carcinoma , cytology , cytopathology , carcinoma , staining , fine needle aspiration , feulgen stain , breast cancer , cancer , biopsy , cervical cancer
Papillary carcinoma (PC) is a histological variant of breast carcinoma that is more frequently observed in males than in females, showing the same cytological features in both sexes. PC is characterized by a low grade of malignancy and a generally favorable course. We describe a case of male breast PC (MPC) diagnosed by fine‐needle cytology (FNC) in which some aggressive morphologically detectable features were associated with bland cytologic features of the tumor. FNC was performed on a 3 cm palpable mass of the left breast of a 55‐yr‐old male. FNC yielded abundant bloody material. Two smears were Diff‐Quik and Papanicolaou stained, others were used for immunocytochemical assessment of estrogen, progesterone, c‐erbB‐2, and Ki‐67; another was Feulgen stained for DNA ploidy. Smears were highly cellular, showing isolated cells and papillary structures. Cells showed tall and well‐defined cytoplasm with a columnar aspect, light anisonucleosis, coarse chromatin, and small nucleoli. Immunoperoxidase staining demonstrated positivity for estrogen (50%), negativity for progesterone, intense positivity for c‐erbB‐2, with specific membrane staining and positivity for Ki‐67 in more than 20% of the cells. DNA‐ploidy showed an aneuploid histogram with 5c exceeding rate (5cER) of 59% and 2c deviation index (2cDI) of 29%. Subsequent surgical pathology examination confirmed the cytological diagnosis of papillary carcinoma; moreover, it revealed neoplastic endolymphatic thrombi and infiltrative border of the tumor that reached the thoracic wall. Cytological features can suggest diagnosis of MPC on FNC samples. Immunocytochemical evaluation of c‐erbB‐2 and Ki‐67 and DNA ploidy evaluation on cytological smears might reveal a biological aggressiveness of PC despite the bland microscopic features of the tumor and this should influence the therapeutic procedure. Diagn. Cytopathol. 2003;29:360–363. © 2003 Wiley‐Liss, Inc.