title: Clinical and cytologic features of papillary neoplasms of the breast.
abstract: OBJECTIVE
  To compare the cytologic features benign and malignant papillary breast lesions.
  
  
  METHODS
  We reviewed the clinical and cytologic features in 29 cases of intraductal papilloma and 26 cases of atypical papilloma or papillary carcinoma that had been diagnosed by histologic examination. The diameter of the mass was examined as a clinical feature. The cytologic features evaluated were as follows: bloody background, row of tall columnar cells, naked bipolar nuclei, hemosiderin-laden macrophages, myoepithelial cells, single scattered atypical cells, cellularity, nuclear atypia, nuclear grade, apocrine metaplasia, eosinophilic cytoplasmic granules, papillary clusters, small papillae, cell balls and large sheets.
  
  
  RESULTS
  Of the features evaluated, the diameter of the mass, naked bipolar nuclei and cell balls differed significantly between benign and atypical or malignant papillary neoplasms. The average diameter of a benign papillary neoplasm was 1.8 cm, and that of an atypical or malignant papillary neoplasm was 2.2 cm (p = 0.042). Naked bipolar nuclei were found in 27 cases of benign papillary neoplasm (93.1%) versus 19 cases of atypical or malignant papillary neoplasm (73.1%) (p = 0.050). Cell balls were found in 14 (48.3%) and 21 (80.8%) cases, respectively (p = 0.012). All 6 cases in which cell balls were present and naked bipolar nuclei were absent proved to be atypical or malignant papillary neoplasms. Of 17 cases in which cell balls were absent and naked bipolar nuclei present, 13 (76.5%) were benign papillary neoplasms.
  
  
  CONCLUSIONS
  Most cytologic features overlapped in benign and atypical or malignant papillary neoplasms. Although they were not pathognomonic, naked bipolar nuclei and cell balls were cytologic features that differed significantly between benign and atypical or malignant papillary neoplasms. When papillary neoplasms of the breast are suspected in a cytologic smear, the combination of clinical examination, mammography and cytologic features should be considered to make the correct diagnosis.
authors.affiliation: Departments of Pathology, Chonnam National University Hospital, Gwangju, Republic of Korea. cchoi@jnu.ac.kr
authors.forename: Yoo Duk
authors.initials: YD
authors.lastname: Choi
authors.forename: Gyung Yub
authors.initials: GY
authors.lastname: Gong
authors.forename: Mi Jung
authors.initials: MJ
authors.lastname: Kim
authors.forename: Ji Shin
authors.initials: JS
authors.lastname: Lee
authors.forename: Jong Hee
authors.initials: JH
authors.lastname: Nam
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Juhng
authors.forename: Chan
authors.initials: C
authors.lastname: Choi
mesh_terms: D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000648:ultrastructure; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology / Q000648:ultrastructure; D004847:Epithelial Cells / Q000473:pathology / Q000648:ultrastructure; D005260:Female; D006801:Humans; D008875:Middle Aged; D018300:Papilloma, Intraductal / Q000175:diagnosis* / Q000473:pathology / Q000648:ultrastructure