title: Pleomorphic carcinoma of the breast associated with cyst formation: a unique surgical case focusing on cytological and immunohistochemical findings. Cystic breast PC.
abstract: A mammary nodular lesion was recognized one month before the surgery in the right upper breast of a 55-year-old female. The fine needle aspiration cytology specimens contained many individual bizarre, multi-nucleated, and/or giant cells having hyperchromatic pleomorphic nuclei, prominent nucleoli, and relatively abundant cytoplasm, admixed with numerous mitotic figures in a hemorrhagic or inflammatory background. A small amount of sheet-like or three-dimensional clusters of malignant cells coexisted. We first interpreted it as high-grade malignancy, such as invasive carcinoma, not otherwise specified. A right breast-conserving surgery was performed, and gross examination revealed a cystic cavity-formed and solid tumor lesion, measuring 35 × 35 × 25 mm and looking gray-yellowish to -whitish. On microscopic examination, the tumor was composed of a diffuse proliferation of highly atypical cells devoid of adhesive characteristics, including many multi-nucleated giant bizarre cells, in a haphazard fashion with stromal invasion, alternating with sarcomatoid features of spindle tumor cells. The cystic cavity was surrounded by hemorrhagic and inflammatory granulation tissue and lined by mostly denuded but atypical tumor cells or bland-looking flattened epithelial cells. Immunohistochemically, these tumor cells are specifically positive for all epithelial markers. Therefore, we made a conclusive diagnosis of pleomorphic carcinoma of the breast with cyst formation. We should be aware that, owing to its characteristic findings, cytopathologists can diagnose correctly, based on careful cytological examination of adequate samplings.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9290689448998782.
authors: Departments of Pathology and Cell Biology, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan. sousuke@med.uoeh-u.ac.jp
authors: Sohsuke
authors: S
authors: Yamada
authors: Atsunori
authors: A
authors: Nabeshima
authors: Yoshika
authors: Y
authors: Nagata
authors: Takashi
authors: T
authors: Tasaki
authors: Hirotsugu
authors: H
authors: Noguchi
authors: Shohei
authors: S
authors: Kitada
authors: Satoshi
authors: S
authors: Kimura
authors: Ke-Yong
authors: KY
authors: Wang
authors: Shohei
authors: S
authors: Shimajiri
authors: Yasuyuki
authors: Y
authors: Sasaguri
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D044963:Biopsy, Fine-Needle / Q000379:methods; D001940:Breast / Q000473:pathology* / Q000601:surgery; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D003560:Cysts / Q000601:surgery*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged
chemical_list: D014408:Biomarkers, Tumor
references: Diagn Pathol. 2013 Feb 27;8:38
references: 23445683
references: Med Mol Morphol. 2009 Jun;42(2):128-31
references: 19536621
references: Diagn Pathol. 2012 Aug 16;7:104
references: 22894137
references: Am J Surg Pathol. 2003 Mar;27(3):311-24
references: 12604887
references: Br J Cancer. 2013 Jul 23;109(2):472-81
references: 23799843
references: Am J Surg Pathol. 2010 Apr;34(4):486-93
references: 20154588
references: Acta Cytol. 1989 Jan-Feb;33(1):109-14
references: 2916357
references: Diagn Cytopathol. 1992;8(4):352-6
references: 1638936
references: Virchows Arch. 2010 Jan;456(1):31-7
references: 20013346
references: Diagn Cytopathol. 1996 Jul;15(1):66-9
references: 8807255
references: Diagn Pathol. 2012 Dec 11;7:175
references: 23231806
references: Diagn Pathol. 2012 May 30;7:61
references: 22647549
references: Cancer. 1989 Dec 15;64(12):2557-64
references: 2819665
references: Med Mol Morphol. 2010 Mar;43(1):43-7
references: 20340005
references: Histopathology. 2000 Jun;36(6):505-14
references: 10849092