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- 乳腺肿快FNA
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本帖最后由 于 2008-10-08 23:08:00 编辑
Granular cell tumour involving the breast parenchyma is a
rare benign lesion. Typically, the smears are
cellular with a prominent degree of dissociation comprising a uniform population of voluminous cells with fragile membranes, abundant eosinophilic, finely granular cytoplasm, some nuclear atypia and bare nuclei. Bare nuclei are frequently encountered; however, these are stripped nuclei with a vesicular or granular chromatin
pattern quite different from the small ovoid bare bipolar nuclei with a homogeneous smudged chromatin pattern of presumed myoepithelial origin typical of benign breast lesions. Factors that can contribute to misinterpretation are: a) rarity of lesion; b) clinical and radiological features of malignancy ‘misleading’ (false Triple Test); c) grittiness of mass to needle tip; d) failure to consider the lesion in the differential diagnosis; e) dispersal of the very fragile cytoplasm leaving nuclei stripped; f) nuclear atypia; and g) the absence of bare bipolar benign nuclei of myoepithelial/ stromal origin. Reference:
ARNOLDUS S. PIETERSE, ANNABELLE MAHAR AND SVANTE ORELL. ARNOLDUS S. PIETERSE, ANNABELLE MAHAR AND SVANTE ORELL. Granular cell tumour: a pitfall in FNA cytology of breast lesions. Pathology (February 2004) 36(1), pp. 58–62 Note: I have the pictures of the final histology on this case. Unfortunately, I don't know how to post them on the web at this time.
Unlike the previous two cases of Salivary gland and pancreas FNA cases, I got a lot of good responses. You considerations are all very good. For those of you who are not very familiar with the Diff-Quick (air-dryed) stain, please pay attention to the THIRD picture (the Pap stain picture) and concentrate on the feature of the cytoplasm? This was a case I saw when I was a cytopathology fellow, the diagnosis was made by my Mentor (Dr. Richard mac DeMay) on cytology, the clinician did not believe him and took the tumor out, and it was what exactly he predicted. It is a rare tumor of the breast. Now I gave you many hints.
CAN YOU GUESS WHAT IT IS???
