Background: The cytologic diagnosis of papillary lesions of the breast is challenging because of the diverse morphology, including epithelial hyperplasia, atypia, low-grade malignancy, and neuroendocrine differentiation; also, traditional malignant features such as necrosis and myoepithelial cell loss can be lacking. Thus, the diagnostic criteria for papillary lesions may differ from those for other breast lesions. This study evaluated various cytologic parameters in a large cohort to identify useful diagnostic features.
Methods: Cytologic preparations of papillary lesions with histologic follow-up were reviewed for features related to cellularity, epithelial cohesiveness, cellular and stromal architecture, cytomorphology, and background. Corresponding histologic slides were also reviewed.
Results: In all, 153 cases were included. Epithelial discohesion, solid and cribriform patterns, atypical nuclear features, and mitoses (P ≤ .001 to P = .017) were associated with malignancy. Cell balls, monolayer sheets, and features of cystic change (P < .001 to P = .016) were associated with benign lesions. Complex (P = .031) and slender (P = .026) papillae and neuroendocrine features (P < .001) were associated with malignancy. Hemorrhage, background, and infiltrating neutrophils (P < .001 to P = .025) were associated with malignancy; fibrotic broad papillary stromal fragments (naked papillary fronds [NPFs]; P = .043) were associated with benignity. The presence of any single parameter, including the absence of myoepithelial cells within epithelial structure, the presence of cytoplasmic granules, an increased amount of cytoplasm, and a nuclear to cytoplasmic (N/C) ratio greater than 0.7, which were identified by principal component analysis, yielded a sensitivity of 95.1% and a specificity of 100.0% in predicting malignancy.
Conclusions: Methodological assessment of multiple features is recommended. Myoepithelial cells, cytoplasmic granules, the amount of cytoplasm, and the N/C ratio are key features for diagnosis.
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http://dx.doi.org/10.1002/cncy.22412 | DOI Listing |
Med Mol Morphol
December 2024
Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
We report a case of solid papillary carcinoma (SPC) that developed at the site of a previous intraductal papilloma (IDP) with atypical ductal hyperplasia. This case supports IDP as a potential precursor lesion to SPC.
View Article and Find Full Text PDFRev Esp Med Nucl Imagen Mol (Engl Ed)
December 2024
Department of Nuclear Medicine, Jinling Hospital, Medical school of NanjingUniversity, Nanjing, Jiangsu Province, 210002, China.
Objective: The aim of this study is to analyze the correlation between [18F]-FDG PET/CT (positron emission tomography/computed tomography) findings and pathological subtypes of lung adenocarcinoma with ground-glass opacity (GGO).
Materials And Methods: 88 patients were included in this study, which underwent [18F]-FDG PET/CT and were finally diagnosed with lung adenocarcinoma. A total of 90 GGO lesions were analyzed.
Pancreatology
December 2024
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA. Electronic address:
Background: Multiple management guidelines for intraductal papillary mucinous neoplasms (IPMNs) have been published to improve risk stratification and resource utilization. This study aims to evaluate trends in endoscopic ultrasound (EUS) use and agreement between cross-sectional imaging and EUS for specific pancreas cystic lesion (PCL) features.
Methods: This retrospective cohort study included consecutive adults undergoing EUS for suspected IPMN detected with cross-sectional imaging (CT/MRCP) between 2013 and 2015 (Cohort 1) and 2018-2020 (Cohort 2).
Clin Lung Cancer
November 2024
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH. Electronic address:
Background: With increased early detection efforts, surgery for early-stage lung cancer is expected to rise. Pafolacianine is the first FDA approved targeted optical imaging agent indicated as an adjunct for intraoperative identification of malignant and nonmalignant pulmonary lesions in adult patients with known or suspected cancer in the lung.
Methods: This is a retrospective review of the malignant and nonmalignant lesions identified by pafolacianine with intraoperative molecular imaging (IMI) in the multi-center Phase 2 and Phase 3 ELUCIDATE clinical trials.
J Hand Surg Glob Online
November 2024
Prisma Health Orthopedics, Columbia, SC.
Digital papillary adenocarcinoma is a rare cutaneous tumor of eccrine origin that often presents as a papule or nodule on the dorsal aspect of a finger. It is challenging to diagnose because of its rarity, its benign appearance, and the lack of specific clinical or histological features. Excision is recommended, given the malignant nature and variable recurrence rates with metastases well documented in the literature.
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