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Metaplastic carcinoma of the breast: cytological diagnosis and diagnostic pitfalls
Deepti Joshi1, Puja Singh, Yvonne Zonunfawni
1Department of Pathology, Mahatma Gandhi Institute of Medical Sciences, Sevagram, India. deeptim75@gmail.com
Objective:
Metaplastic carcinoma of the breast is a rare malignant neoplasm comprised of ductal, squamous and/or mesenchymal elements in various proportions. Fine needle aspiration diagnosis of this entity is problematic because of its pathological heterogeneity. In this study, we have described the cytomorphological features of histologically confirmed metaplastic carcinomas and also discussed the diagnostic limitations along with a brief review of the literature.
Study Design:
In this observational study, the histology and cytology files of all cases identified as metaplastic carcinomas during the study period (2004-2009) were retrieved. The slides were reviewed for the presence of various elements.
Results:
Ten cases were identified as metaplastic carcinomas during the study period. All cases were diagnosed as malignant on cytology. Three cases showed presence of squamous carcinoma cells, 4 showed presence of atypical spindle cells, 2 showed presence of mesenchymal fragments and 1 showed presence of osteoclastic giant cells.
Conclusion:
The presence of biphasic tumor cells, atypical spindle cells admixed with poorly differentiated carcinoma cells, squamous carcinoma cells, osteoclastic giant cells and matrix may provide clues for the fine needle aspiration diagnosis of metaplastic carcinomas. However, cytological diagnosis may not be possible in all the cases because of selective sampling of various pathological elements.
