Diagnosis of Infarcted Breast Lesions on FNAC, a Blustering Fool: Short Case Series.

Introduction: Fine-needle aspiration cytology (FNAC) is often used as a screening tool. Cytopathologist should be aware of various mimickers of the malignancy. One of these is infarction of benign breast lesions. Careful examination of cytomorphological features will avoid the misdiagnosis of malignancy in such cases. Material and Methods: Six cases were diagnosed as benign breast lesion for 4 years and 5 months in our newly established tertiary referral center. Histopathology follow-up was available in one case. Results: Of six cases, three cases (50%) were reported as fibroadenoma with infarction, two cases (33%) as benign breast lesion with infarction favor fibroadenoma, and one as breast lesion with infarction favor phyllodes tumor in view of recurrence. Most were in the second or third decade of their life. All cases showed dyscohesive cells with pyknotic nuclei. Monolayered sheets of necrotic cells were seen in the four cases (66%). Viable cells were seen in four cases. Conclusions: FNAC provides a rapid and accurate diagnosis of benign breast lesions with infarction in the hands of experienced pathologists who can help in better patient care. Small-sized uniform pyknotic nuclei of dyscohesive cells and regular nuclear membranes help to differentiate them from inflammatory and malignant lesions.

Evaluation of Role of Intraoperative Cytology Technique in Diagnosis and Management of Cancer.

CONTEXT: Intraoperative pathological assessment provides valuable information in a patient's diagnosis and management. Touch imprint/crush cytology is simple, rapid, and cost-effective. Also, imprint smears give excellent cytomorphology. AIMS: To assess the utility and feasibility of intraoperative cytology technique as a rapid and reliable method for diagnosis and to compare sensitivity, specificity and diagnostic accuracy with histopathology. MATERIALS AND METHODS: Cytology smears were collected intraoperatively from 52 cases of suspected/proven malignancy. From tumors, surgical margins, lymph nodes; crush, imprint, and scrape smears were prepared. Smears were taken from specimens before formalin fixation and stained with rapid ultrafast Papanicolaou stain. The slides were compared with the histopathology report which is the gold standard. STATISTICAL ANALYSIS: Sensitivity, specificity, and diagnostic accuracy were used for statistical analysis. RESULTS: Intraoperative cytology report could be given in time for the surgeon to modify margins of resection and the extent of lymph node dissection. It helps the surgeon to modify surgery. The diagnostic test evaluation showed satisfactory results. CONCLUSION: Intraoperative imprint/crush cytology is a simple, inexpensive, rapid, accurate cytodiagnostic technique in the diagnosis of cancer where frozen section facilities are not available. It can also be used to assess the clearance of surgical margins.