Cytologic findings with histologic correlation in 43 cases of mammary intraductal XXXX diagnosed by aspiration biopsy.

@entity1 @entity3821 @entity39 @entity189 @entity1893 @entity420
OBJECTIVE: To review the cytologic and subsequent histologic findings in intraductal mammary @entity420 ( @entity420 in situ) ( @entity3821 ) to evaluate the role of aspiration biopsy (AB) in identifying and grading the disease. STUDY DESIGN: AB smears and tissue sections from 43 @entity1 with pure @entity3821 who underwent preoperative AB were reviewed. Smears were assessed for cellularity, cellular arrangement (including dissociation, nuclear size and @entity1893 ), and presence of nucleoli and @entity39 . RESULTS: Of the 43 cases, 22 were high grade (HG) @entity3821 , 7 cases were intermediate grade (IG), and 14 cases were low grade (LG). Cytologic findings of HG @entity3821 was as follows: high cellularity (22/22), clusters of pleomorphic cells with large nuclei and increased nuclear/cytoplasmic ratios (22/22), single cells (20/22), prominent nucleoli (22/22) and @entity39 (diffuse in 15/22, focal in 7/22). All LG cases had moderately to highly cellular smears with cohesive, 3-dimensional sheets of uniform, small cells with inconspicuous nucleoli arranged around a central lumen, forming "punched-out" spaces. Single cells were prominent in 2 of 14 cases. IG @entity3821 showed intermediate features between LG and HG @entity3821 : 3-dimensional sheets with punched-out spaces, abundant single cells, moderate @entity1893 and focal @entity39 . CONCLUSION: HG @entity3821 is easily identifiable on AB smears; however, distinction from @entity189 may not be possible. The cytologic diagnosis of LG @entity3821 is difficult, and 50% of our cases were called atypical on AB. Recognition of cohesive cellular arrangements with crowding and punched-out spaces is crucial as single cells and prominent atypia are often lacking.
