title: Cytologic findings of breast ductal lavage and concurrent fine needle aspiration in pleomorphic lobular carcinoma in situ: a case report.
abstract: BACKGROUND
  Breast ductal lavage (DL) is a noninvasive procedure for sampling ductal epithelial cells. Patients at risk for breast cancer or with prior history can be monitored by DL. This report compares cytomorphology in concurrent DL, fine needle aspiration (FNA) and histology in a case of pleomorphic lobular carcinoma in situ (PLCIS) with signet ring features.
  
  
  METHODS
  A 57-year-old woman had DL and FNA performed after quadrantectomy for lobular carcinoma in situ with signet ring cell features. DL and FNA were diagnosed as suspicious and positive for malignancy, respectively. Subsequent biopsy showed PLCIS. Cytomorphologic features of DL, FNA and histology were compared. DL showed epithelial cells in small clusters or single-file arrangement and single-lying; in FNA, single cells predominated. DL and FNA showed nuclear atypia and cytoplasmic vacuoles, the latter more prevalent in FNA. Both samples showed cells with signet ring features. The atypical epithelial cells present in DL and FNA were identical to those seen in the histologic material.
  
  
  CONCLUSIONS
  Cytomorphologic findings in DL, although less striking, are comparable to those seen in FNA. Architecture, nuclear atypia and intracytoplasmic vacuoles are helpful features in DL for establishing a diagnosis of suspicious if not positive for malignancy in LCIS.
authors.affiliation: Cytology Unit, Department of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy.
authors.forename: Mara Jo
authors.initials: MJ
authors.lastname: Miller
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Cazzaniga
authors.forename: Chiara
authors.initials: C
authors.lastname: Casadio
mesh_terms: D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology*; D018275:Carcinoma, Lobular / Q000473:pathology*; D018279:Carcinoma, Signet Ring Cell / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D007507:Therapeutic Irrigation / Q000379:methods*; D014617:Vacuoles / Q000473:pathology