Diagnosis Case6

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Discussion Case #6

“Scanty aspirate”

“Negative for tumor?”

nWait n
nTry & place the cells first

nLarger than RBC’s

nNo particular feature of malignancy

nNo nucleoli

nBut the N:C ratio is altered

nThere is hyperchromasia

Thought process

nAre they inflammatory cells?
nHistiocytes?
nEpithelial cells?
nBenign or malignant?
n
nWould it be prudent to ask for a repeat aspirate? Or a FS
nClinician may also be vague about the nature of the ‘lump’

Tata Memorial Hospital Experience

nAnalysis of 40 cases n
nMany ‘Lob Ca’ aspirates were scanty or too sparse for interpretation n
nOn review many of our reports were ‘false negative’ cases n
nThe criteria for malignancy were subtle or virtually non existent

nSingly scattered cells or cells in short chains

nNo nuclear characters of malignancy

nComet shapes found

nNo nucleoli- sometime grooves seen

nN:C ration altered

nClinically no mammographic findings

nOn palpation- granular feel or hard ill defined vague nodularity

Giemsa stain is often more reassuring

Diagnosis

Lobular Carcinoma

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Discussion Case #6
	n



	“Scanty aspirate” “Negative for tumor?” n nWait n nTry & place the cells first nLarger than RBC’s nNo particular feature of malignancy nNo nucleoli nBut the N:C ratio is altered nThere is hyperchromasia
	Thought process
	nAre they inflammatory cells? nHistiocytes? nEpithelial cells? nBenign or malignant? n nWould it be prudent to ask for a repeat aspirate? Or a FS nClinician may also be vague about the nature of the ‘lump’



	Tata Memorial Hospital Experience
	nAnalysis of 40 cases n nMany ‘Lob Ca’ aspirates were scanty or too sparse for interpretation n nOn review many of our reports were ‘false negative’ cases n nThe criteria for malignancy were subtle or virtually non existent nSingly scattered cells or cells in short chains nNo nuclear characters of malignancy nComet shapes found nNo nucleoli- sometime grooves seen nN:C ration altered nClinically no mammographic findings nOn palpation- granular feel or hard ill defined vague nodularity

		Giemsa stain is often more reassuring

	Diagnosis *Lobular Carcinoma*