Cytologically Yours: Unknowns: 201312: Case 4

Contents

Clinical History

25 year old female. Right breast core touch prep.

Cytology

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Resident Questions

• Diagnosis?

• Cytology diagnosis: Benign ductal epithelial cells with lactational changes.
• Surgical diagnosis: Lactation adenoma

Surgical Pathology

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Cytologic Features

• The distinction between and adenoma and lactational change on cytology is extremely difficult (impossible).
• Hypercellar smears
• Loosely cohesive fragments
• Larger cells with prominent nucleoli
• Vacuolated cytoplasm
• Naked nuclei may be present in the background.
• Dirty background with inflammatory cells, macrophages, proteinaceous debris, blood
• May be initially confused with carcinoma.