Solitary intraductal papilloma of the breast--a diagnostic dilemma and the role of conferencing between surgeons and cytologist.
A 40 year female, presented with the complaints of spontaneous, sticky, blood stained discharge from the nipple of the left breast since 6 months. On examination there was no lump palpable in either breast. Cytology of the nipple discharge (ND) showed scanty cellularity consisting of tight papillary clusters of ductal cells in a hemorrhagic and inflammatory background. The nuclei were bland and showed degenerative atypia. Mammography showed no significant lesion. Our patient underwent microdochechtomy. Histopathology showed intraductal papilloma. Limitations of cytology must be kept in mind by both, the pathologist and the surgeon. The cytological diagnosis of a papillary tumor is provisional and the definitive diagnosis must await histological examination. In view of rarity of this lesion, combined with the overlapping of cytologic features in benign and malignant papillary lesions, conferencing and communication with the surgeon should be an integral part of patient evaluation and management. In our case this approach resulted in less radical excision of breast tissue.
Meherbano
Kamal M
KM
Department of Pathology, Shri V. N. Govt. Medical College, Yavatmal, Nagpur. drkamal3@rediffmail.com
Jaywant
Mahadani
M
Girish
Jatkar
J
Kiran
Bharti
B
Sanjay
Khandekar
K
Anjali
Joshi
J
Nilima
Lodha
L
Dilip
Sarate
S
Vikas
Yedshikar
Y
Ratnamala
Kamble
K
Walde
Mahesh S
MS
D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D003581:Cytodiagnosis; D005260:Female; D013502:General Surgery; D006801:Humans; D033183:Interdisciplinary Communication; D009558:Nipples / Q000378:metabolism / Q000473:pathology; D018300:Papilloma, Intraductal / Q000175:diagnosis* / Q000473:pathology*; D010336:Pathology