Drs. Prolla and Diehl's CASE OF THE MONTH August 2007



FNA breast nodule, 66-year old male: gynecomastia (false positive cytology)

500x M-G-G staining, loose cluster of ductal cells, with some nuclear moulding

Gynecomastia, false positive cytology, 500x M-G-G staining, loose cluster with anisonucleosis

G, ynecomastia, false positive cytology500x M-G-G staining, hyperchromatic nuclei

Gynecomastia, false positive cytology, 500x M-G-G staining, loose cluster with nuclear crowding, slight anisonucleosis

200x H&E staining, typical aspect of gynecomastia, proliferating ducts and loose stroma

500x H&E staining, in the high power view, the multilayered ductal epithelium has some clearly atypical cells

The smears show sheets of epithelial cells, no stroma nor myoepithelial cells. The evenly distributed chromatin, the absence of nucleoli, the regular oval shape of the nuclei, are noteworthy. However, the somewhat dyscohesive nature of the sheets, their relatively small size, and the absence of myoepithelial cells, made us to call the case a well differentiated ductal cell carcinoma. Surgery revealed the nodule to be gynecomastia with moderate atypical proliferation of the duct epithelium. One year later, the patient had a colonic carcinoma diagnosed and resected.



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