FINE-NEEDLE ASPIRATION CYTOLOGY OF CYSTIC HYPERSECRETORY CARCINOMA OFTHE BREAST - A CASE-REPORT

``BACKGROUND: Cystic hypersecretory carcinoma (CHC) of the breast is i t rare variant of intraductal carcinoma. It is characterized by a mult icystic, yellow-brown lesion with gelatinous material grossly and cyst ically dilated ducts with an eosinophilic secretion microscopically. T he histologic or cytologic features can be deceptively bland. CASE: A 37-year-old female presented with an 8-cm-diameter, firm mass in the b reast. Radical mastectomy was performed after fine needle aspiration ( FNA). The moderately cellular smear had a characteristic background of proficient, intensely staining secretion with bubbling. The cellular components were various, ranging from sheets of benign hyperplastic du ctal cells to three-dimensional clusters or papillae of frankly malign ant ductal cells, with varying degrees of secretory activity. The back ground consisted of inflammatory cells, naked nuclei and foamy histioc ytes. The cytologic findings correlated well with the histologic featu res of the tumor, which showed both micropapillary intraductal carcino ma with apocrine metaplasia and focal high grade invasive carcinoma in a background of cystic hypersecretory hyperplasia. CONCLUSION: This w as the first reported case of FNA cytology of an invasive form of CHC. CHC has characteristic features on FNA, and so a reliable diagnosis c an be made.