March 2014

Author: Christopher J VandenBussche MD PhD; The Johns Hopkins Hospital, Baltimore, MD; USA.

Case History: A 45 year old woman has a 3.1 cm, palpable breast mass. The mass is solitary, mobile, and painless. The patient is concerned because she did not notice the mass last month and it seems to be growing rapidly. Breast ultrasound demonstrates a solid mass containing multiple cleft-like cystic spaces and posterior acoustic enhancement, with vascularization of the solid component. Fine needle aspiration of the breast mass is performed and the following are representative smears from the resulting specimen.

Figure 1 (DiffQuik stain)

Figure 2 (DiffQuik stain)

Figure 3 (DiffQuik stain)

Figure 4 (DiffQuik stain)

Figure 5 (Pap Stain stain)

Figure 6 (Pap Stain stain)

Given the clinical presentation, radiological data and cytomorphological findings, which of the following are true about the patient’s most likely diagnosis?