乳腺管状腺瘤在细胞学上不同于纤维腺瘤。

IF 1.6 4区 医学 Q3 PATHOLOGY
Acta Cytologica Pub Date : 2023-01-01 DOI:10.1159/000527773
Joshua J X Li, Joanna K M Ng, Billy S W Lai, Conrad H C Lee, Ka-Ho Shea, Julia Y Tsang, Gary M Tse
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引用次数: 0

摘要

越来越多的分子证据表明乳腺管状腺瘤与纤维上皮性病变不同,因此在世界卫生组织第五次乳腺肿瘤分类中将其重新分类为上皮性肿瘤。然而,管状腺瘤在细针穿刺细胞学(FNAC)上的特征仍然很差,通常不能与纤维腺瘤区分开来。在这项研究中,迄今为止最大的队列,组织学证实的管状腺瘤的吸气和纤维腺瘤的吸气进行了回顾和比较。本研究结果进一步明确了管状腺瘤的细胞学特征,并允许与纤维腺瘤鉴别。方法:回顾组织学证实的管状腺瘤的抽吸物,了解其背景、肌上皮、上皮和基质成分的特征,然后与纤维腺瘤的抽吸物进行比较。结果:共纳入管状腺瘤43例,纤维腺瘤94例。管状腺瘤表现为中等上皮细胞,具有高内聚性,间质碎片含有上皮。小管在管状腺瘤中更为常见(p = 0.009),“管状碎片”(包含多个管状结构的组织碎片,有/没有间质)是管状腺瘤的一个病理特征(p < 0.001)。钙化和纤维囊性改变的发生率各不相同(4.65 ~ 13.5%),但纤维腺瘤无差异(p > 0.05)。所有管状腺瘤的抽吸均未见细胞形态学上的恶性特征和有丝分裂。小管和间质碎片的存在是与管状腺瘤相关的独立因素,而大上皮碎片和裸露间质碎片的优势与纤维腺瘤相关。结论:管状腺瘤不仅在组织学和分子上与纤维上皮病变分离,而且在FNAC上是一个不同的实体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Tubular Adenomas of the Breast Are Cytologically Distinct from Fibroadenomas.

Tubular Adenomas of the Breast Are Cytologically Distinct from Fibroadenomas.

Tubular Adenomas of the Breast Are Cytologically Distinct from Fibroadenomas.

Tubular Adenomas of the Breast Are Cytologically Distinct from Fibroadenomas.

Introduction: Increasing molecular evidence indicates that tubular adenoma of the breast is distinct from fibroepithelial lesions, leading to its reclassification as an epithelial tumor in the 5th World Health Organization classification of tumors of the breast. However, tubular adenoma remains poorly characterized on fine-needle aspiration cytology (FNAC) and often not distinguished from fibroadenomas. In this study, the largest cohort, to date, of histologically confirmed aspirates of tubular adenomas were reviewed and compared with aspirates of fibroadenomas. Findings from this study further define the cytological features of tubular adenoma and allow differentiation from fibroadenoma.

Methodology: Aspirates of histologically confirmed tubular adenomas were reviewed for features of the background, myoepithelial, epithelial, and stromal components and then compared to a cohort of aspirates of fibroadenomas.

Results: Totally, 43 (tubular adenoma) and 94 (fibroadenoma) aspirates were included. Tubular adenomas displayed moderate epithelial cellularity with high cohesiveness, with stromal fragments containing epithelium. Tubules are more common in tubular adenomas (p = 0.009) and "tubular fragments" (tissue fragments containing multiple tubular structures with/without stroma) is a pathognomonic feature of tubular adenoma (p < 0.001). Calcification and fibrocystic changes were variably seen (4.65-13.5%) but without difference to fibroadenomas (p > 0.05). Cytomorphologically malignant features and mitoses were absent in all aspirates of tubular adenoma. Presence of tubules and stromal fragments were independent factors associated with tubular adenomas, whereas a predominance of large epithelial fragments and naked stromal fragments were associated with fibroadenomas.

Conclusion: Tubular adenomas are not only histologically and molecularly separate from fibroepithelial lesions but also a distinct entity on FNAC.

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来源期刊
Acta Cytologica
Acta Cytologica 生物-病理学
CiteScore
3.70
自引率
11.10%
发文量
46
审稿时长
4-8 weeks
期刊介绍: With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.
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