ABSTRACT
Screening mammography and greater community awareness of breast carcinoma have led to an increase in fine needle biopsies of the breast. As a consequence, a wide variety of cytologic patterns have been encountered and studied in benign, proliferative, and malignant breast lesions. We review the main reasons for diagnostic difficulties in breast cytology, the situations in which either a false positive or a false negative diagnosis is possible, as well as conditions whose incorrect typing can lead to inappropriate management.
Subject(s)
Adenocarcinoma/pathology , Biopsy, Fine-Needle/methods , Breast Neoplasms/pathology , Breast/pathology , Diagnosis, Differential , False Negative Reactions , False Positive Reactions , Female , HumansABSTRACT
A review of pitfalls encountered in fine needle aspiration cytology (FNAC) of all organs and tissues and based mainly on the author's 35-year experience of diagnostic FNAC in clinical practice is presented. Diagnostic difficulties are usually related to deviations from common cytological criteria that may occur in some lesions. Others are due to the effects of the sampling procedure or of the preparation of samples. A few basic rules are proposed, which may help to avoid some of the diagnostic pitfalls.
Subject(s)
Biopsy, Fine-Needle , Biopsy, Fine-Needle/methods , Biopsy, Fine-Needle/standards , Contraindications , Diagnostic Errors , Female , Humans , Male , Neoplasms/pathologyABSTRACT
The cytologic features of five cases of epithelial-myoepithelial carcinoma arising in major salivary glands (four parotid and one submandibular gland) are presented. All cases were initially diagnosed as low-grade malignancies. The smears were generally cellular, with no specific architectural pattern. Single cells and naked nuclei were prominent in all cases. A biphasic epithelial (small-cell) and myoepithelial (large/clear-cell) pattern was identified readily in two cases and with difficulty in one case. The biphasic pattern may be subtle or absent since the clear cells have a fragile cytoplasm and often appear as naked nuclei. The differential diagnosis includes adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, and cellular pleomorphic adenoma.
