Non-gynaecological Cytology
Breast cytology
Anatomy and histology of the breast
Nipple discharge cytology
Fine needle aspiration (FNA)
Reporting terminology
Evaluation of the specimen
Benign lesions
Breast carcinoma
Phyllodes tumor

 

Papillary carcinoma

Pure papillary carcinoma is rare in breast, although a papillary component may be present in up to 3-4% of breast carcinomas. It typically occurs in postmenopausal women.
FNA smears show three-dimensional papillary groupings of cells, some with fibro-vascular cores, with scattered columnar tumour cells and a bloody diathesis with haemosiderin-laden macrophages in the background. Nuclear atypia is often mild.

Cytological diagnostic features

  • Moderate cellularity
  • Three-dimensional papillary groups, fibro-vascular cores
  • Atypical columnar cells
  • Haemosiderin-laden macrophages

The differential diagnosis includes fibroadenoma, (favoured by the presence of finger-like branching without a fibro-vascular core and bipolar naked nuclei in the background), and papilloma. It is often very difficult to distinguish well-differentiated papillary carcinoma from benign papilloma, and surgical excision is advised when a papillary neoplasm is diagnosed by FNA cytology.

 

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