By Gary Tse, Puay Hoon Tan, Fernando Schmitt
This e-book offers a close replace on all points of fine-needle aspiration cytology of breast lesions. it's going to serve readers as an updated reference and atlas on either new entities in breast pathology, together with borderline lesions resembling flat epithelial atypia, and the vintage benign and malignant lesions. all through, emphasis is put on the attribute diagnostic good points in addition to the typical pitfalls confronted through cytologists. As cytologic positive aspects should be hugely variable, corresponding cytology and histology photographs are displayed jointly, allowing readers to achieve an excellent realizing of the morphologic positive factors of assorted lesions. Core-needle biopsy and fine-needle aspiration cytology are in comparison intensive, with awareness to their relative strengths and weaknesses and symptoms. furthermore, the influence of molecular category of breast cancers on cytologic prognosis is explored, and using molecular options in diagnostic cytology is discussed.
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Extra resources for Fine Needle Aspiration Cytology of the Breast: Atlas of Cyto-Histologic Correlates
One of the keys to performing an adequate aspiration is the immobilization of the lesion by the aspirator’s free hand as better cutting or coring of the mass can be achieved. The needle, with syringe and holder attached, is then inserted into the mass. The syringe plunger is pulled back, creating negative pressure, as the needle is advanced forward and backward. It is not the suction that directly results in obtaining a sample but rather the cutting action of the needle. The suction helps to pull tissue into the cutting path of the needle and to move the resulting fragments up into the needle’s shaft (Fig.
Lesion location. If the location is subareolar, one should consider the possibility of a papillary neoplasm, nipple adenoma or subareolar abscess. • A cystic lesion suggests fibrocystic disease. Exception occurs when the aspirate is markedly cellular with single columnar cells; then one should consider a papillary neoplasm. In addition, the acquisition of thin, watery greengray fluid typical of benign cyst fluid of fibrocystic changes should caution against an overdiagnosis of carcinoma even when some of the cells present show degenerative nuclear atypia.
Multiple aspirations yield little significant tissue. The problem typically encountered here is that the aspirator has not placed the needle deep enough. The aspirator erroneously thinks that most of the deeply seated firmness is chest wall instead of tumor and not wanting to risk a pneumothorax, the aspirates are made too superficial. An additional difficulty arises from the tendency of most aspirators to approach lesions with the needle positioned tangentially to the skin, rather than with a near vertical or perpendicular approach.