March 2011

Bryan Knight, MB, ChB; M Med (Anat. Path); PhD; FIAC
Head of Cytology, Queensland Medical Laboratories, Brisbane,
Queensland, Australia

CASE HISTORY:
A 49 year old female presented with clinical and radiologic features of fibrocystic disease with micro-calcifications. She underwent a fine needle aspiration of the lesion situated 7cm from the nipple at 2 o’clock in the left breast. One Dif Quick and three Papanicolaou stained smears were received in the laboratory.

Cytomorphology of the case: (Figures 1-11):
The cellular smears show atypical epithelial cells predominantly arranged in groups, in a background of abundant necrotic material with lymphocytes.  Cells are found in cohesive groups, loosely cohesive clusters and as occasional single cells.  The cells show pleomorphism of nuclei with oval, spindled and multinucleate cells.  The nuclei show coarse granular chromatin and nucleoli are present.  Many of  the groups of cells are intensely orangiophilic. Others cells show abundant pale staining cytoplasm, with slight orangiophilia when stained with Papanicolaou stain. Occasional large single cells and with pleomorphic nuclei and coarsely granular chromatin are present.  Some bizarre giant cells show abundant intensely orangiophilic cytoplasm.

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Fig. 1 Pap 40x
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Fig. 2 Pap 100x
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Fig. 3 Dif Quick 200x
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Fig. 4 Dif Quick 400x
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Fig. 5 Pap 100x
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Fig. 6 Pap 400x
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Fig. 7 Pap 400x
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Fig. 8 Pap 400x
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Fig. 9 Pap 400x
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Fig. 10 Pap 400
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Fig. 11 Pap 400

 

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