Evaluation of Cytomorphological Patterns of Fibroadenoma on Cytology: Emphasis on Pattern based approach to avoid misdiagnosis
DOI:
https://doi.org/10.3329/bjms.v21i3.59572Keywords:
Fibroadenoma; bimodal; Fine needle aspiration cytology; cytomorphological; cytohistologicalAbstract
Background: Fibroadenoma (FA) is a frequently occurring breast lesion diagnosed on fine needle aspiration cytology (FNAC) with a bimodal picture comprising of epithelial and/or stromal component. It can have a gamut of differential diagnosis depending on the predominant cellular features reflected on cytological smears, thereby it is important that the cytologist should be well versed with the various patterns of fibroadenoma to avoid diagnostic errors.
Materials and methods: The present study was conducted over a period of two years including all cases of fibroadenoma diagnosed on cytology (n=234). The detailed cytomorphological spectrum was analysed to study the different patterns of fibroadenoma on cytology. Out of these (234), cytohistological correlation was performed in 197 cases.
Results: The incidence of fibroadenoma among all the breast FNACs was 50% (234/468). The different patterns observed were: epithelial predominant, stromal predominant, FA with giant cells, apocrine change, cyst macrophages, granuloma, acute inflammation and atypia. Cytohistologic concordance was observed in 173/197 cases (87.8%). Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were 98.8%, 92.3%, 87.8%, 94.5% and 88.8% respectively.
Conclusion: Although fibroadenoma can be diagnosed with ease on cytology in most of the cases, However, at times in addition to classical features, morphological variations are observed such as giant cells, cyst macrophages, apocrine change, granulomas, acute inflammation and atypia wherein it maybe misdiagnosed as benign phyllodes, hyperplasia, fibrocystic disease etc.. This pattern based approach for the cytological diagnosis of FA is re-emphasized in the index article so as to create awareness about these varied patterns among the young cytopathologists.
Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 590-595
Downloads
295
615
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Varsha Chauhan, Charu Agarwal, Mukta Pujani, Sujata Raychaudhuri, Kanika Singh, Nimisha Sharma, RK Chandoke
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish in the Bangladesh Journal of Medical Science agree to the following terms that:
- Authors retain copyright and grant Bangladesh Journal of Medical Science the right of first publication of the work.
Articles in Bangladesh Journal of Medical Science are licensed under a Creative Commons Attribution 4.0 International License CC BY-4.0.This license permits use, distribution and reproduction in any medium, provided the original work is properly cited.- Authors are able to enter into separate, additional contractual arrangements for the distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted to post their work online (e.g., in institutional repositories or on their website) as it can lead to productive exchanges, as well as greater citation of published work.
