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Cytologic findings in infiltrating micropapillary carcinoma and mucinous carcinomas with micropapillary pattern
Bhulaxmi Madur1, Tanuja Shet, Roshni Chinoy
1Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, India.
Objective:
To examine the observation that some mucinous carcinomas have a micropapillary pattern and are mucinous variants of the highly angioinvasive infiltrating micropapillary carcinomas (IMPC).
Study Design:
We evaluated cytologic findings of 13 IMPC and 55 mucinous carcinomas for comparative features.
Results:
In mucinous carcinomas, 37 of 50 (74%) had a micropapillary pattern. This group included 27 cases with pure mucinous micropapillary morphology (MUMPC), 8 MUMPC associated with a ductal carcinoma of the IMPC type (MUIDC) and 2 cases of mixed mucinous carcinomas with an MUMPC and a solid variant ofpapillary carcinoma (SVPC) component. On cytology both IMPC and mucinous carcinomas with micropapillary pattern demonstrated the micropapillary pattern, that is, angulated clusters or abortive papillae and ball-like clusters. However, the IMPC smears revealed numerous singly scattered tumor cells and larger fragments with shrub-like branching and the MUMPC had psammoma bodies. The mixed MUMPC and SVPC showed the classic cytologic features of MUMPC admixed with abundant singly dispersed tumor cells in the background representing the SVPC component.
Conclusion:
Although IMPC and the MUMPC share the micropapillary pattern on histologic examination, mucin alters the appearances in aspirates. Recognition of this morphologic spectrum will help in understanding the behavior of these tumors.
Insights
Mucinous carcinomas can exhibit a micropapillary pattern, presenting as mucinous variants of infiltrating micropapillary carcinomas (IMPC). Recognizing this morphologic spectrum is key to understanding tumor behavior.
Area of Science:
- Surgical pathology
- Cytopathology
- Oncology
Background:
- Some mucinous carcinomas display a micropapillary pattern.
- These may represent mucinous variants of infiltrating micropapillary carcinomas (IMPC).
Purpose of the Study:
- To compare cytologic findings of IMPC and mucinous carcinomas.
- To identify shared and distinct features of mucinous carcinomas with a micropapillary pattern.
Main Methods:
- Cytologic evaluation of 13 IMPC cases.
- Cytologic evaluation of 55 mucinous carcinoma cases.
Main Results:
- 74% of mucinous carcinomas (37/50) showed a micropapillary pattern.
- Mucinous carcinomas with micropapillary pattern (MUMPC) and IMPC share features like angulated clusters.
- IMPC smears had scattered single cells and shrub-like fragments, while MUMPC had psammoma bodies.
Conclusions:
- Histologically, IMPC and MUMPC share a micropapillary pattern.
- Mucin significantly alters the cytologic appearance of MUMPC compared to IMPC.
- Understanding this spectrum aids in predicting tumor behavior.
