Cytodiagnosis of nipple discharge: a study of 602 samples from 484 cases.

To find out the gross and microscopic differentiating features between nipple discharges (ND) due to various breast lesions, smears of 602 ND samples from 484 cases were reviewed by one of the investigators (D.K.D.). The reviewed cytodiagnoses were as follows: benign nipple discharge (59.1%), inflammatory ND (6.5%), ?papillary lesions (2.5%), papillary lesions (20.6%), papillary lesions with atypia (3.8%), duct cells with atypia (0.2%), suspicious for malignancy (0.5%), malignant ND (1.2%), and inadequate (5.6%). Following review, samples with epithelial abnormalities (?papillary lesion, papillary lesion with and without atypia, duct cells with atypia, suspicious for malignancy, and malignancy) increased from 16.6% to 30.4% of adequate samples (P < 0.0001). 37.9% unilateral ND samples showed epithelial abnormalities, as opposed to 18.9% of bilateral ND samples (P < 0.0001). Bloodstained ND showed epithelial abnormalities in 41.5% samples, as compared to 22.1% of ND with other specified gross characteristics (P < 0.0001). The samples with epithelial abnormalities differed significantly from benign and inflammatory ND in respect of frequency of benign duct cells, duct cells with atypia, papillary clusters with or without atypia, malignant cells, columnar cells, red blood cells, inflammatory cells, and background lipid vacuoles (P < 0.01 to < 0.0001). The ND samples with suspicious and malignant cytology, besides the presence of malignant cells (P < 0.0001), differed significantly from rest of the lesions in respect of foam cells (P < 0.0001), red blood cells (P < 0.01), and inflammatory cells (P < 0.05). When compared with histopathological diagnosis in 20 cases, the benign or malignant nature of the lesion was correctly identified in ND in 80% cases. The ND cytologies in 7 histologically proved malignant cases were malignancy (3 cases), suspicious for malignancy (1 case), papillary lesion with atypia (1 case), papillary lesion (1 case), and benign ND (1 case).

Benign disorders of the prostate: A histopathological study.

Although the medical literature contains adequate accounts of the pathophysiology of various benign prostatic disorders, it is often necessary to revisit these lesions, to reexamine the relationships between known benign lesions and more sinister, malignant disorders, in the light of new advances in our understanding of the processes. We carried out a histopathological review of prostatic surgical pathology material seen over a sevenyear period in our hospital. Our findings show that benign enlargement of the prostate or benign prostatic hyperplasia (BPH) is initially fibromuscular in many cases, becoming glandulostromal with advancing age. While we found no relationship between prostatitis and age, individual gland necrosis tended to occur relatively early and correlated well with stromal repair, which we believe forms the basis of fibromuscular hyperplasia. Epithelial hyperplasia may result from glandular regeneration, and basal cell hyperplasia, papillary hyperplasia and cribriform hyperplasia all showed significant correlation with prostatic intraepithelial neoplasia (PIN). On the other hand, only cribriform hyperplasia showed correlation with atypical adenomatous hyperplasia (AAH), and also demonstrated an increase in incidence with advancing age. Our findings underline the positive relationships between benign events such as glandular necrosis with repair and epithelial hyperplasia, which may itself predispose to recognized premalignant lesions such as PIN.