The background
Unit 6 of 8
Name the lesion from what lies between the cells: stroma, apocrine sheets, cyst fluid, inflammation, fat and mucin.
What lies between the cells names the lesion more often than the cells do. A fibroadenoma brings stromal fragments with it. Fibrocystic change brings apocrine sheets and a proteinaceous background. An abscess brings pus. A lipoma brings fat. A mucinous carcinoma brings mucin.
The answer key for this unit is the source laboratory's own report line for that patient, normalised only in spelling. It describes the lesion the patient had, not this one patch, and the unit is honest about that difference.
The drill gives you six report lines and asks for the one that fits.
The entities, quoted
Fibroadenoma
Normally reported as C2 Benign.
A cytologist would look for
large ductal epithelial tissue fragments and plentiful bare bipolar nuclei and fibrillary or rounded stromal fragments
high cellularity and dispersal and a degree of nuclear enlargement are still acceptable for a benign diagnosis
Fibrocystic change or cyst
Normally reported as C2 Benign.
A cytologist would look for
sheets of metaplastic apocrine cells, slightly enlarged cohesive tissue fragments of ductal epithelial cells
small, oval and dark myoepithelial nuclei, oval bare bipolar nuclei
apocrine sheets in a proteinaceous background
Benign proliferative lesion or epithelial hyperplasia
Normally reported as C2 Benign.
A cytologist would look for
overlapping cytological features between proliferative breast lesions, such as usual epithelial hyperplasia, intraductal papillomas and fibroadenomas, and low-grade in situ lesions and low-grade invasive carcinomas
Lactational change
Normally reported as C2 Benign.
Mastitis, abscess or inflammatory lesion
Normally reported as C2 Benign.
A cytologist would look for
pus consistent with an abscess
Lipoma
Normally reported as C2 Benign.
Fat necrosis
Normally reported as C1 Insufficient or inadequate.
Mucinous carcinoma
Normally reported as C5 Malignant.
The worked example
Loading the case library.
About 20 trials, 5 to 8 minutes. You can stop at any point.