• The Korean Journal of Cytopathology
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• v.7 no.2
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• pp.202-206
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• 1996

Metaplastic carcinoma of the breast is a morphologically heterogenous group of neoplasms characterized by ductal adenocarcinoma with extensive squamous differentiation, a spindle-cell pattern of growth, and/or heterologous mesenchymal elements. We experienced a case of metaplastic carcinoma diagnosed by fine needle aspiration(FNA) and confirmed by radical mastectomy in a 46 year-old woman. The FNA cytologic findings included atypical squamous cells with kertinization tying singly and in clusters in a necrotic background. In addition, scattered spindle cells with pleomorphic large nuclei and prominent nucleoli were present in a hemorrhagic and necrotic background. The histopathologic findings showed moderately differentiated squamous cell carcinoma and highly pleomorphic sarcoma with chondroid component. The immunohistochemical stain revealed focal positive reaction for cytokeratin as well as diffuse reactivity for vimentin in the sarcomatous area.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6221-6225
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• 2013

Metaplastic breast cancer (MBC) is a rare type of breast carcinoma, characterized by various combinations of mesenchymal, adenocarcinoma and other epithelial components. MBC often manifests as a large mass, with low axillary lymph node involvement and poor prognosis. Knowledge and treatment patterns about MBC demographics, presentation and tumor characteristics are very limited. In clinical practice, MBC is usually treated based on the guidelines developed for infiltrating ductal carcinoma (IDC). The ideal treatment paradigm for MBC is unknown due to its low incidence and pathological variability, so potential predictors of treatment efficacy need to be explored. This review summarizes the current models and strategies for MBC according to the published literature.

• The Korean Journal of Cytopathology
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• v.8 no.2
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• pp.174-178
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• 1997

Matrix producing carcinoma of the breast is a variant of heterologous metaplastic carcinoma which is defined as "overt carcinoma with direct transition to a cartilaoenous and/or osseous stromal matrix without an intervening spindle cell zone or osteoclastic cells". This tumor is very rare, occuring in less than 0.2% of total breast carcinoma, but the prognosis is better than other metaplastic carcinoma. We experienced a case of fine needle aspiration(FNA) cytologic finding of matrix producing carcinoma of the breast. A 75-year old woman, who presented a right huge breast mass$(9{\times}8cm)$ during 10months, was examined. Mammography reveals right lateral mass with even density without calcification. Breast ultrasonography shows multifocal hypoechogenic cystic change in the huge mass, suggesting resolving hematoma or carcinoma or sarcoma with necrosis. On cytologic finding of FNA, myxoid matrix was the dominant feature and the rest of the material was composed of scanty isolated atypical cells with large irregular nuclei. The histologic finding was moderately differentiated adenocarcinoma with abundant cartilagenous matrix and focal squamous metaplasia.

• Journal of the Korean Society of Radiology
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• v.83 no.6
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• pp.1385-1393
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• 2022

Metaplastic carcinoma of the breast is a heterogeneous group of neoplasms with mixed epithelial and mesenchymal differentiation. Metaplastic carcinoma of the breast is a rare and aggressive malignancy, with high recurrence and metastasis. Metaplastic carcinoma with chondroid differentiation is an uncommon subtype that tends to have a relatively good prognosis than that of other subtypes. We report the imaging features of three cases of pathologically proven metaplastic carcinoma with chondroid differentiation as follows: a high-density mass with amorphous or coarse heterogeneous calcifications on mammography; a microlobulated or partially indistinct, complex cystic, and solid mass on sonography; and a relatively circumscribed or partially indistinct, irregular mass with heterogeneous T2 high-signal intensity and heterogeneous or rim enhancement with initial fast enhancement and delayed washout on MRI.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4645-4649
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• 2012

Metaplastic breast carcinoma (MpBC) is a rare disease entity, accounting for less than 1% of all breast carcinomas. Furthermore, it is a heterogenous disease with different subgroups, including malignant epithelial (carcinoma) and stromal (sarcoma) features. Here we evaluated, retrospectively, 14 female MpBC patients admitted to Ankara Oncology Training and Research Hospital between 2005 and 2011. Median age was 45.5 (range:16.0-76.0) and tumor size 57.5 mm (range: 20.0-80.0 mm). Histopathological subtypes were as follows: 5 carcinosarcoma, 5 squamous and 4 adenosquamous carcinoma. All but one with upfront lung metastasis, had their primary breast tumor operated. Axillary lymph nodes were involved in 64.3%. The most common sites of metastasis were lungs and brain. Chemotherapy including antracycline, taxane and even platinium was planned for adjuvant, neoadjuvant and palliative purposes in 9, 3 and 1 patient, respectively. Median cycles of chemotherapy was 6 (range:4-8). Median follow-up of the patients was 52 months (95%CI 10.4-93.6 month). Median 3 year progression free survival (PFS) and overall survival (OS) in this patients cohort were 33% and 56%, respectively. In conclusion, MpBC is a rare and orphan disease without standardized treatment approaches and the prognosis is poor so that larger studies to investigate different treatment schedules are urgently needed.

• The Korean Journal of Cytopathology
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• v.3 no.2
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• pp.67-74
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• 1992

Apocrine carcinoma is a rare form of breast malignancy and is composed of entirely or predominantly of apocrine type epithelial cells. Apocrine metaplastic cells are frequently noted in fine needle aspiration cytology(FNAC) of breast lesions, especially fibrocystic disease. These apocrine cells may occasionally be atypical, to make a diagnostic difficulty. Two cases of apocrine carcinoma of the breast diagnosed by FNAC are described, and differential cytologic points between apocrine metaplasia and apocrine carcinoma are discussed. The first case is a right breast mass of a 37-year-old woman for 20 days. The smears show many single or sheets of large cells on bloody background. Each cell has a large vesicular nuclei with multiple macronucleoli and abundant eosinophilic granular cytoplasm. The second case is a left breast mass of a 35-year-old woman for one month. The smears show similar findings as seen in the first one. Histopathologic findings of both cases are typical of apocrine carcinoma. Electron microscopy demonstrates variable numbers of large osmiophilic granules in diameter of $200\sim600nm$ in both cases.

• The Korean Journal of Cytopathology
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• v.11 no.1
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• pp.47-52
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• 2000

Diffuse sclerosing papillary carcinoma(DSPC), a variant of papillary carcinoma of the thyroid, is characterized by diffuse involvement of one or both thyroid lobes, and histologic features such as prominent sclerosis, intense lymphocytic infiltrate, numerous psammoma bodies, and squamous metaplasia together with the characteristic cytoarchitectural pattern of classical papillary carcinoma. We experienced a case of fine needle aspiration cytologic(FNAC) findings of DSPC, which was confirmed by histologic examination of the thyroidectomy specimens. The patient was 26 years old female who presented with diffuse firm enlargement of the thyroid gland with enlargement of many cervical lymph nodes. FNAC smears showed numerous psammoma bodies, many lymphocytes, metaplastic squamous cells, absence of stringy colloid, and epithelial cells showing classical features of papillary carcinoma, such as nuclear grooves, intranuclear unclusions, and ground glass chromatin pattern.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2851-2856
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• 2014

The aim of this study is to evaluate clinicopathologic characteristics and the multi-disciplinary treatment results of metaplastic breast cancer (MBC) patients treated in a single institute. Seventeen female patients with MBC treated in our department between June 2000 and January 2012 were identified and retrospectively evaluated. The median age at diagnosis was 46 years (range, 26-66 years). The median tumor size at diagnosis was 3.5 cm (range 1.5-12 cm). Six (35%) patients underwent breast conservation surgery and 11 (65%) mastectomy. Axillary lymph node metastasis was found in 6 (35%) patients. Twelve (71%) had triple negative tumors. Postoperative RT and systemic adjuvant treatment was given to all patients accordingly to stage and biological characteristics. Median follow-up time was 27 months (range, 12-151 months). At the time of this analysis, 14 (82%) patients were alive with no evidence of disease, and 1 (6%) was alive with disease. The 3-year OS was 91% and 5-year 80%, and DFS rates were 76% and 76%, respectively. Despite the young age of our patients with mostly high grade tumors, larger tumor size and higher rates of lymph node metastasis, the survival outcomes in our study are favorable in comparison with previously reported series.

• Journal of Yeungnam Medical Science
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• v.23 no.2
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• pp.152-161
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• 2006

Carcinoma of the gallbladder is an uncommon but highly malignant tumor with a poor five year survival rate. Early detection is very important for successful treatment because this tumor is very hard to cure in cases where it has advanced beyond the reach of surgical treatment. The purpose of this review was to evaluate risk factors for carcinoma of the gallbladder and determine the best management approach.. Solitary polys, more than one cm are considered to be predisposing factors for gallbladder carcinoma when they are found to be echopenic, sessile, and with a high cell density. Anomalous union of the pacreato-biliary duct(AUPBD) without a choledochal cyst is also considered to increase risk for gallbladder carcinoma. A polyps size of more than one cm and an AUPBD are indications for prophylactic cholecystectomy. The presence of gallstones is a well-established risk factor for the development of gallbladder carcinoma; risk appears to correlate with the stone size and the duration of chronic cholecystitis. Metaplastic changes of the gallbladder epithelium present with chronic cholecystitis and may indicate a premalignant lesion. Abnormal forms of cholecystitis such as xanthogranulomatous or a porcelain gallbladder also have malignant potential; cholecystoenteric fistula as well as bacterial infection of the gallbladder(typhoid, helicobacter species) also has malignant potential. In this review, the risk factors associated with carcinoma of the gallbladder are summarized with special attention to gallstones, polyps, AUPBD, and chronic inflammation.

• The Korean Journal of Cytopathology
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• v.16 no.2
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• pp.106-109
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• 2005

We report a case of Warthin's tumor of the parotid gland in a 53 year old man, which is incorrectly diagnosed as squamous cell carcinoma. Fine needle aspiration cytology(FNAC) smear obtained from the right parotid gland revealed scattered epithelial cell clusters or nests in a diffuse inflammatory and necrotic background. Some epithelial cells had squamoid appearance showing variable sized bizarre shaped nuclei. They had abundant of dense eosinophilic keratinized cytoplasm. Occasionally, parakeratotic cells were also present. These cytologic findings with significant atypia and necrotic background made diagnosis as squamous cell carcinoma. But, the resection specimen from this patient showed classic Warthin's tumor in addition to abundant areas of inflammation and squamous metaplasia. Metaplastic or infarcted Warthin's tumor in the salivary gland may be confused with false positive diagnosis of malignancy on FNAC. Therefore, cytopathologist should have adequate awareness of potential of erroneous diagnosis in FNAC of Warthin's tumor.