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A Cytomorphologic Study of Benign and Malignant Papillary Neoplasms of the Breast.

Ho Jung LEE ; Gyungyub GONG ; Bohng Hee KIM ; Sei Hyun AHN ; Jeong Mi PARK ; Jooryung HUH ; Shin Kwang KHANG ; Jae Y RO

Korean Journal of Cytopathology.1999;10(1):27-34.

Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations. To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carci nomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papil lomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma. Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(67%). Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma. Malignant lesions tended to show higher cellularity and more single isolated cells. The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor.
Breast* ; Carcinoma, Papillary ; Epithelial Cells ; Macrophages ; Metaplasia ; Needles ; Noma ; Papilloma ; Papilloma, Intraductal ; Retrospective Studies

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The Significance of Nuclear Size in Nuclear Grade of Invasive Ductal Carcinoma of the Breast.

Young Kyung BAE ; Dong Sug KIM ; Hye Jung CHOI ; Mi Jin GU ; Soo Jung LEE ; Jea Young LEE

Korean Journal of Cytopathology.1999;10(1):21-26.

To make the objective standard of nuclear size in grading nuclear pleomorphism of invasive ductal carcinoma of the breast, we measured maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections from 65 cases by using computer-based image analysis system(Optimas 6.0). The maximal diameter of red blood cells were also measured to evaluate the ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells. The mean values of maximal nuclear diameter of tumor cells on imprint cytology slides and histologic sections were 7.56 micrometer, 7.53 micrometer in nuclear grade 1, 8.92+/-0.98 micrometer, 9.02+/-0.74 micrometer in nuclear grade 2, and 12.90+/-1.47 micrometer, 12.44+/-1.41 micrometer in nuclear grade 3, respectively. There were no significant differences between values of imprint cytology and histologic section. The ratio of maximal nuclear diameter of tumor cells to maximal diameter of red blood cells were 1.3-1.4:1 in nuclear grade 1, 1.6-1.7:1 in nuclear grade 2, and 2.2-2.3:1 in nuclear grade 3. These values would be guidelines for grading nuclear pleomorphism of invasive ductal carcinoma of the breast on routine surgical pathology work.
Breast* ; Carcinoma, Ductal* ; Erythrocytes ; Pathology, Surgical

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Transthoracic Fine Needle Aspiration Cytology of the Lung.

Min Suk KIM ; In Ae PARK ; Sun Hoo PARK ; Sung Shin PARK ; Hwal Wong KIM ; Kyung Chul MOON ; Young Ah KIM ; Hye Seung LEE ; Ki Wha PARK ; Jeong wook SEO ; Hyun Soon LEE ; Eui Keun HAM

Korean Journal of Cytopathology.1999;10(1):13-19.

The authors analysed 2,653 cases of transthoracic fine needle aspiration cytology of the lung to evaluate the diagnostic accuracy and its limitation. A comparison was made between the original cytologic and the final histologic diagnoses on 1,149 cases from 1,074 patients. A diagnosis of malignancy was established in 38.3% benign in 48.1%, atypical lesion in 2.3%, and inadequate one in 11.9% of the cases. Statistical data on cytologic diagnoses were as follows; specificity 98.9%: sensitivity of procedure, 76.8%: sensitivity of diagnosis, 95.5%: false positive 5 cases: false negative 18 cases: predictive value for malignancy, 98.8%: predictive value for benign lesion, 79.5%: overall diagnostic efficiency, 87.5%: typing accuracy in malignant tumor, 80%.
Biopsy, Fine-Needle* ; Diagnosis ; Humans ; Lung* ; Sensitivity and Specificity

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Availability of Toluidine Blue Stain in Body Fluid.

Hye Kyung LEE ; Myung Jin JOO ; Kwang Min LEE ; Eun Hee LEE ; Sang In SIM

Korean Journal of Cytopathology.1999;10(1):7-11.

We evaluated the availability of toluidine blue stain in body fluids, such as peritoneal and pleural fluid and urine. Nine hundreds specimens, i.e., 400 pleural and 400 peritoneal fluids and 100 urine samples, respectively, from Jan. 1995 to May 1996 were included. We obtained the result of high sensitivity and high specificity in toluidine blue stained body fluid in comparison with Papanicolaou stained result. Additionally, we found the diagnostically important crystals in chylothorax and some urine samples, which can not be seen in routine Papanicolaou stain. We thought the toluidine blue stain in body fluid is one of very useful diagnostic methods.
Ascitic Fluid ; Body Fluids* ; Chylothorax ; Sensitivity and Specificity ; Tolonium Chloride*

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Comparison of Qualified Diagnosis of "Atypical Squamous Cells of Undetermined Significance" with Subsequent Biopsy.

Jae Soo KOH ; Jin Haeng CHUNG ; Seung Sook LEE ; Kyung Ja CHO

Korean Journal of Cytopathology.1999;10(1):1-5.

To evaluate whether different qualifications of a cytologic diagnosis of "atypical squamous cells of undetermined significance(ASCUS)" predict a greater or lesser likelihood of tissue diagnosis of uterine cervix, we compared different cytologic qualifications of ASCUS with the tissue diagnosis. One hundred twenty-two con secutive Papanicolaou smears showing ASCUS in women who had undergone cervical biopsy within nearest 30 days were collected. The 122 smears were qualified as "favor reactive"(25%), "favor low grade squamous intraepithelial lesion (LSIL)"(24%), "favor squamous intraepithelial lesion(SIL)"(16%), "favor high grade squa mous intraepithelial lesion(HSIL)"(16%), and "not otherwise specified"(19%). Squamous intraepithelial or invasive lesion was pathologically confirmed by cervical biopsy in 13% of the "favor reactive", 27% in "favor LSIL", 70% in "favor SIL", 75% in "favor HSIL", and 35% in "not otherwise specified" smears. There were significant asso ciations between the favor reactive smear and the benign biopsy finding and between the favor SIL smear and the biopsy showing a squamous intraepithelial or more severe lesion. Nevertheless, most of favor LSIL smears exhibit reactive process in tissue biopsy. Conclusively, qualified ASCUS stratifies women into different risk groups for SIL. The cytopathologist should make the cytologic diagnosis of "ASCUS, favor LSIL" circumspectly.
Biopsy* ; Cervix Uteri ; Diagnosis* ; Female ; Humans ; Papanicolaou Test

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Fine Needle Aspiration Cytology of the Intraductal Papillary Mucinous Tumor of the Pancreas: A Case Report.

In Gu DO ; Jae Hoon PARK ; Youn Wha KIM ; Ju Hie LEE ; Moon Ho YANG ; Sung Wha HONG ; Yong Koo PARK

Korean Journal of Cytopathology.2003;14(2):91-95.

Intraductal papillary mucinous tumor of the pancreas is characterized by intraductal papillary proliferation of mucin-producing epithelial cells with or without excessive mucin secretion. According to the degree of epithelial dysplasia, intraductal papillary mucinous tumor is classified into adenoma, borderline tumor, and carcinoma. We recently experienced a case of fine needle aspiration cytology of the intraductal papillary mucinous adenoma in a 69-year-old male. The fine needle aspiration cytology yielded flat sheets of columnar, mucin containing epithelial cells in the background of dense mucin containing degenerated cellular material and histiocytes.
Adenoma ; Aged ; Biopsy, Fine-Needle* ; Epithelial Cells ; Histiocytes ; Humans ; Male ; Mucins* ; Pancreas*

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Fine Needle Aspiration Cytology of Kimura's Disease of Parotid Gland: Report of A Case Cytologically Failed to Diagnose as Kimura's Disease.

Se Hoon KIM ; Haeryoung KIM ; Sung Eun KIM ; Woo Ick YANG ; Soon Won HONG ; Kwang Gil LEE

Korean Journal of Cytopathology.2003;14(2):86-90.

Kimura's disease is a chronic inflammatory disorder of unknown cause and is most prevalent among Asians. The cytologic findings of Kimura's disease are significant numbers of eosinophils in a background of lymphoid cells, occasional fragments of collagenous tissue, proliferation of vessels, and Warthin-Finkeldey polykaryocytes. Among these features, the most important cytologic feature of Kimura's disease is a significant numbers of eosinophils. We experienced a case of Kimura's disease in the parotid gland which we failed to recognize on cytology due to the apparent paucity of eosinophils. On careful retrograde reviewing of the cytologic findings, a few scattered leukocytes, previously interpreted as polymorphous leukocytes, had bilobed nuclei and coarse green but granular cytoplasm on Papanicolaou preparation. These leukocytes showed obvious orange-red intracytoplasmic granules as in eosionophils on Giemsa stain. The paucity of eosinophils may be due to the thick fibrosis around lymphoid follicles or any technical error during aspiration. Whereas the Warthin-Finkeldey type giant cell is not a sensitive cytologic marker of Kimura's disease, it may be a helpful cytologic feature. To reach a correct cytologic diagnosis of Kimura's disease, it is important to keep in mind that searching for Warthin-Finkeldey type giant cells and evaluation of Giemsa stain for detection of eosinophils would be helpful.
Asian Continental Ancestry Group ; Azure Stains ; Biopsy, Fine-Needle* ; Collagen ; Cytoplasm ; Diagnosis ; Eosinophils ; Fibrosis ; Giant Cells ; Humans ; Leukocytes ; Lymphocytes ; Parotid Gland*

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Urine Cytology of Prostatic Adenocarcinoma: A Case Report.

Won Ae LEE ; Mi Seon KWON ; Jai Hyang KO ; Na Hye MYONG

Korean Journal of Cytopathology.2003;14(2):82-85.

Prostatic adenocarcinoma cells can be detected in urine cytology specimens when the tumor extends to the bladder mucosa. We report a case of prostatic adenocarcinoma diagnosed by urine cytology. A 70-year-old man presented with urinary frequency and low back pain. On rectal examination, a nodular mass was palpated in the left side of prostate. Bone scan revealed multifocal hot lesions suggesting metastasis. Urine cytology revealed hypocellular smear on clean or bloody background. Tumor cells were mainly arranged in syncytial or papillary clusters which occasionally contained foci of luminal formation. The cytoplasm of tumor cells was finely granular. The nuclei of tumor cells revealed evenly distributed fine chromatin and large prominent nucleoli without nuclear pleomorphism. In needle biopsy specimen of prostate, tumor cells were detected in entire prostatic tissue with extension to pericapsular soft tissue. The tumor cells infiltrated individually or in a cord-like fashion with foci of cribriform pattern. Inconspicuous nuclear pleomorphism and prominent nucleoli were also noted.
Adenocarcinoma* ; Aged ; Biopsy, Needle ; Chromatin ; Cytoplasm ; Humans ; Low Back Pain ; Mucous Membrane ; Neoplasm Metastasis ; Phenobarbital ; Prostate ; Urinary Bladder

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The Fine Needle Aspiration Cytologic Features of Apocrine Carcinoma of the Breast: A Case Report.

Minseob EOM ; Jin Kyu PARK ; Soon Hee JUNG ; Kwang Gil LEE

Korean Journal of Cytopathology.2003;14(2):76-81.

Apocrine carcinoma of the breast is a very rare subtype. Although it has no clinical differences from usual ductal carcinoma of the breast, it should be categorized as a subtype of breast carcinoma because the cells of apocrine carcinoma reveal characteristic abundant eosinophillic cytoplasms with intraductal apical snouting as well as round or oval nuclei and central macronucleoli. On fine needle aspiration cytology, the cells of apocrine carcinoma have a lot of similarity to benign or reactive apocrine cells of the breast. Therefore, it is difficult to make a differential diagnosis of apocrine carcinoma from mammary neoplasms with similar cytologic findings unless the subtle cytologic differences are recognized. We report the cytologic and histologic findings of a case of apocrine carcinoma in the breast of a 40-year-old female patient. After the fine needle aspiration cytology, she received the lumpectomy and lymph node dissection. The cellularity was moderate to high. The cytoplasmic borders of tumor cells of three-dimensional clusters were relatively distinctive, and the cytoplasm was abundant, eosinophilic, and granular. Although the nuclear/cytoplasmic ratio was low, the nuclei of the cells were variable in size and shape with prominent macronucleoli. Histologically, it was a typical invasive apocrine carcinoma, showing numerous cytoplasmic lysosomes and mitochondriae on electron microscopy.
Adult ; Animals ; Apocrine Glands ; Biopsy, Fine-Needle* ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal ; Cytoplasm ; Diagnosis, Differential ; Eosinophils ; Female ; Humans ; Lymph Node Excision ; Lysosomes ; Mammary Neoplasms, Animal ; Mastectomy, Segmental ; Microscopy, Electron ; Mitochondria

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Uterine Tumor Resembling Ovarian Sex-Cord Tumor: A Case Report of the Cytologic Finding.

Insun KIM ; Eun Mee HAN ; Woon Yong JUNG ; Ju Han LEE ; Bum Woo YEOM

Korean Journal of Cytopathology.2003;14(2):71-75.

Uterine stromal tumors with features of ovarian sex-cord differentiation are relatively rare. The neoplasms composed of sex cord-like components in more than 50% of the tumor are classified as group II. We report the cytologic findings of a case of uterine tumor resembling ovarian sex-cord tumor. The cervical smears of a 62-year-old woman with submucosal tumor showed loose aggregates of spindle cells as well as glandular or tubular structures of round cells with a distinct cell membrane and a prominent small nucleolus. Because uterine stromal tumor can have sex cord differentiation, its possibility should be considered in the interpretation of cervical smears.
Cell Membrane ; Female ; Humans ; Middle Aged ; Uterus ; Vaginal Smears

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