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Fine-needle aspiration detects primary neuroendocrine carcinoma of the breast in a patient with breast implants.

Malowany JI, Kundu U, Santiago L, Krishnamurthy S - Cytojournal (2015)

Bottom Line: Breast augmentation with implantation represents a challenge for subsequent radiographic imaging and pathological sampling.A definite diagnosis of mammary carcinoma with plasmacytoid cells was made on ultrasound (US)-guided FNAB of the breast mass with rapid on-site evaluation which initiated core needle biopsy of the mass and subsequent mastectomy with sentinel lymph node biopsy.In addition, the case illustrates the cytomorphological features of the tumor cells in primary neuroendocrine carcinoma of the breast.

View Article: PubMed Central - HTML - PubMed

Affiliation: Address: Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 0053, Houston, TX 77030, USA.

ABSTRACT
Breast augmentation with implantation represents a challenge for subsequent radiographic imaging and pathological sampling. Fine-needle aspiration biopsy (FNAB) is an excellent technique to sample suspicious lesions that are adjacent to fragile implants. We report a case of a 51-year-old woman with breast implants presenting with an initial diagnosis of fibroadenoma by imaging studies. A definite diagnosis of mammary carcinoma with plasmacytoid cells was made on ultrasound (US)-guided FNAB of the breast mass with rapid on-site evaluation which initiated core needle biopsy of the mass and subsequent mastectomy with sentinel lymph node biopsy. Our case exemplifies the role of US-guided FNAB for the initial investigation of breast masses in patients with implants. In addition, the case illustrates the cytomorphological features of the tumor cells in primary neuroendocrine carcinoma of the breast.

No MeSH data available.


Related in: MedlinePlus

Fine-needle aspiration smears show increased cellularity with mostly single, dispersed cells and occasional larger clusters of plasmacytoid cells. The nuclei are relatively monomorphic, eccentrically placed and have fine nuclear chromatin. (a, b) Pap smear. (c) Diff-Quik
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Figure 1: Fine-needle aspiration smears show increased cellularity with mostly single, dispersed cells and occasional larger clusters of plasmacytoid cells. The nuclei are relatively monomorphic, eccentrically placed and have fine nuclear chromatin. (a, b) Pap smear. (c) Diff-Quik

Mentions: The FNAB smears showed high cellularity with many dispersed single intact atypical epithelial cells and very few loose clusters. The epithelial cells exhibited a striking plasmacytoid appearance with a moderate amount of granular eosinophilic cytoplasm. The nuclear chromatin of the cells was fine without conspicuous nucleolus. Rare mitotic figures were identified. There was no evidence of mucin vacuoles in the atypical cells. Naked bipolar nuclei were absent in the background of the smears. The overall cytomorphological findings were consistent with a well- to moderately-differentiated mammary carcinoma with plasmacytoid features, raising concern for a neuroendocrine carcinoma [Figure 1]. Due to the lack of cell block material from the FNAB, a CNB was subsequently performed under US guidance [Figure 2].


Fine-needle aspiration detects primary neuroendocrine carcinoma of the breast in a patient with breast implants.

Malowany JI, Kundu U, Santiago L, Krishnamurthy S - Cytojournal (2015)

Fine-needle aspiration smears show increased cellularity with mostly single, dispersed cells and occasional larger clusters of plasmacytoid cells. The nuclei are relatively monomorphic, eccentrically placed and have fine nuclear chromatin. (a, b) Pap smear. (c) Diff-Quik
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325382&req=5

Figure 1: Fine-needle aspiration smears show increased cellularity with mostly single, dispersed cells and occasional larger clusters of plasmacytoid cells. The nuclei are relatively monomorphic, eccentrically placed and have fine nuclear chromatin. (a, b) Pap smear. (c) Diff-Quik
Mentions: The FNAB smears showed high cellularity with many dispersed single intact atypical epithelial cells and very few loose clusters. The epithelial cells exhibited a striking plasmacytoid appearance with a moderate amount of granular eosinophilic cytoplasm. The nuclear chromatin of the cells was fine without conspicuous nucleolus. Rare mitotic figures were identified. There was no evidence of mucin vacuoles in the atypical cells. Naked bipolar nuclei were absent in the background of the smears. The overall cytomorphological findings were consistent with a well- to moderately-differentiated mammary carcinoma with plasmacytoid features, raising concern for a neuroendocrine carcinoma [Figure 1]. Due to the lack of cell block material from the FNAB, a CNB was subsequently performed under US guidance [Figure 2].

Bottom Line: Breast augmentation with implantation represents a challenge for subsequent radiographic imaging and pathological sampling.A definite diagnosis of mammary carcinoma with plasmacytoid cells was made on ultrasound (US)-guided FNAB of the breast mass with rapid on-site evaluation which initiated core needle biopsy of the mass and subsequent mastectomy with sentinel lymph node biopsy.In addition, the case illustrates the cytomorphological features of the tumor cells in primary neuroendocrine carcinoma of the breast.

View Article: PubMed Central - HTML - PubMed

Affiliation: Address: Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 0053, Houston, TX 77030, USA.

ABSTRACT
Breast augmentation with implantation represents a challenge for subsequent radiographic imaging and pathological sampling. Fine-needle aspiration biopsy (FNAB) is an excellent technique to sample suspicious lesions that are adjacent to fragile implants. We report a case of a 51-year-old woman with breast implants presenting with an initial diagnosis of fibroadenoma by imaging studies. A definite diagnosis of mammary carcinoma with plasmacytoid cells was made on ultrasound (US)-guided FNAB of the breast mass with rapid on-site evaluation which initiated core needle biopsy of the mass and subsequent mastectomy with sentinel lymph node biopsy. Our case exemplifies the role of US-guided FNAB for the initial investigation of breast masses in patients with implants. In addition, the case illustrates the cytomorphological features of the tumor cells in primary neuroendocrine carcinoma of the breast.

No MeSH data available.


Related in: MedlinePlus