Exploring cytologic features and potential diagnostic challenges of metastatic NUT carcinoma to the parotid gland: A case report and a comprehensive literature review Crystal Y. Li, Salih Salihoglu, Francisco J. Civantos, Jaylou M. Velez Torres Diagnostic Cytopathology.2024;[Epub] CrossRef
NUT carcinoma of the submandibular gland: A case report Simone Rota, Pasquale Quattrone, Giovanni Centonze, Gianpaolo Dagrada, Arianna Ottini, Elena Colombo, Imperia Nuzzolese, Giuseppina Calareso, Marzia Franceschini, Nicola Alessandro Iacovelli, Federica Perrone, Elena Tamborini, Stefano Cavalieri Cancer Reports.2023;[Epub] CrossRef
NUT carcinoma of the parotid gland: report of two cases, one with a rare ZNF532-NUTM1 fusion Min Chen, Sha Zhao, Zuoyu Liang, Weiya Wang, Ping Zhou, Lili Jiang Virchows Archiv.2022; 480(4): 887. CrossRef
NUT Carcinoma: Clinicopathologic Features, Molecular Genetics and Epigenetics Vanessa Moreno, Karan Saluja, Sergio Pina-Oviedo Frontiers in Oncology.2022;[Epub] CrossRef
Salivary Gland NUT Carcinoma with Prolonged Survival in Children: Case Illustration and Systematic Review of Literature Huiying Wang, Vivian L. Weiss, Robert D. Hoffman, Ty Abel, Richard H. Ho, Scott C. Borinstein, Kyle Mannion, Julia A. Bridge, Jennifer Black, Jiancong Liang Head and Neck Pathology.2021; 15(1): 236. CrossRef
NUT Carcinoma of the Submandibular Gland: A Case at This Uncommon Site with Review of the Literature Vanessa Moreno, Christopher A. French, Tianhua Guo, Hui Zhu, Songling Zhang, Darryl Duncan, Ron J. Karni, Angel I. Blanco, Syed H. Jafri, Karan Saluja Head and Neck Pathology.2021; 16(3): 881. CrossRef
Prevalence of NUT carcinoma in head and neck: Analysis of 362 cases with literature review Taebum Lee, Junhun Cho, Chung‐Hwan Baek, Young‐Ik Son, Han‐Sin Jeong, Man Ki Chung, Sang Duk Hong, Yong Chan Ahn, Dong Ryul Oh, Jae Myoung Noh, Keunchil Park, Myung‐Ju Ahn, Hyung‐Jin Kim, Yi Kyung Kim, Young Hyeh Ko Head & Neck.2020; 42(5): 924. CrossRef
HDAC Overexpression in a NUT Midline Carcinoma of the Parotid Gland with Exceptional Survival: A Case Report Gonçalo Esteves, Joana Ferreira, Rita Afonso, Carmo Martins, Carlos Zagalo, Ana Félix Head and Neck Pathology.2020; 14(4): 1117. CrossRef
Lung nuclear protein in testis carcinoma in an elderly Korean woman: A case report with cytohistological analysis Hwa Jin Cho, Hyun‐Kyung Lee Thoracic Cancer.2020; 11(6): 1724. CrossRef
Clinicopathological and Preclinical Findings of NUT Carcinoma: A Multicenter Study Minsun Jung, Soyeon Kim, June-Koo Lee, Sun Och Yoon, Heae Surng Park, Soon Won Hong, Weon-Seo Park, Ji Eun Kim, Joon Kim, Bhumsuk Keam, Hyun Jik Kim, Hyoung Jin Kang, Dong-Wan Kim, Kyeong Cheon Jung, Young Tae Kim, Dae Seog Heo, Tae Min Kim, Yoon Kyung Je The Oncologist.2019; 24(8): e740. CrossRef
NUT Carcinoma of the Salivary Glands Abbas Agaimy, Isabel Fonseca, Carmo Martins, Khin Thway, Ryan Barrette, Kevin J. Harrington, Arndt Hartmann, Christopher A. French, Cyril Fisher American Journal of Surgical Pathology.2018; 42(7): 877. CrossRef
Abrupt Dyskeratotic and Squamoid Cells in Poorly Differentiated Carcinoma: Case Study of Two Thoracic NUT Midline Carcinomas with Cytohistologic Correlation Taebum Lee, Sangjoon Choi, Joungho Han, Yoon-La Choi, Kyungjong Lee Journal of Pathology and Translational Medicine.2018; 52(5): 349. CrossRef
A Case of Nuclear Protein in Testis Midline Carcinoma Arising From the Submandibular Gland Duct in a Pregnant Patient Younghoon Cho, Bhum Suk Keam, Kyeong Cheon Jung, Bo Hae Kim Journal of Oral and Maxillofacial Surgery.2017; 75(9): 2020. CrossRef
Pediatric NUT-midline carcinoma: Therapeutic success employing a sarcoma based multimodal approach Simone Storck, Alyssa L. Kennedy, Karen J. Marcus, Lisa Teot, Jennifer Vaughn, Astrid K. Gnekow, Bruno Märkl, Ivo Leuschner, Steven G. DuBois, Christopher A. French, Michael C. Frühwald Pediatric Hematology and Oncology.2017; 34(4): 231. CrossRef
Two Cases of Nuclear Protein in Testis Midline Carcinomas of Sinonasal Tract Minhyung Lee, Yong Seok Kang, Tae-Bin Won, Hyun Jik Kim Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2017; 60(12): 673. CrossRef
Cytological features of NUT midline carcinoma arising in sino‐nasal tract and parotid gland: Report of two new cases and review of the literature Jerzy Klijanienko, Christophe Le Tourneau, José Rodriguez, Martial Caly, Stamatios Theocharis Diagnostic Cytopathology.2016; 44(9): 753. CrossRef
Cytological Features of a Variant NUT Midline Carcinoma of the Lung Harboring theNSD3-NUTFusion Gene: A Case Report and Literature Review Shiho Kuroda, Shioto Suzuki, Akira Kurita, Mari Muraki, Yoichiro Aoshima, Fumihiko Tanioka, Haruhiko Sugimura Case Reports in Pathology.2015; 2015: 1. CrossRef
A 37-year-old female presented with a conjunctival mass discovered 3 years prior. An excisional biopsy revealed a patternless proliferation of round and spindle-shaped cells with an eosinophilic fibrillary cytoplasm and vesicular nuclei with occasional inclusions. Psammoma bodies were arranged around the dilated irregularly-shaped vessels.
Differential diagnoses included conjunctival solitary fibrous tumor (SFT), nevus, glomangioma, ectopic meningioma, and mesectodermal leiomyoma. The tumor cells were immunoreactive for CD34, CD99, bcl-2 and vimentin, and were negative for smooth muscle actin, desmin, glial fibrillary acidic protein, S-100 protein, epithelial membrane antigen, and human melanoma black-45. Ultrastructurally, the tumor cells had rough endoplasmic reticulum, free ribosomes, and scattered mitochondria without basal lamina or cellular junctions, which are features of fibroblasts. A diagnosis of SFT was rendered based on the light microscopic, immunohistochemical, and electron microscopic findings. We report here on the second case of a SFT arising in the conjunctiva, which clinically and histologically mimics conjunctival nevus, glomangioma, ectopic meningioma, and a hybrid neurogenic-myogenic tumor such as mesectodermal leiomyoma.
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Meningeal Solitary Fibrous Tumors with Delayed Extracranial Metastasis Nayoung Han, Hannah Kim, Soo Kee Min, Sun-Ha Paek, Chul-Kee Park, Seung-Hong Choi, U-Ri Chae, Sung-Hye Park Journal of Pathology and Translational Medicine.2016; 50(2): 113. CrossRef
Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumor of uncertain origin, and it has a strong propensity for metastasis to the lungs, bones and brain. We report upon an unusual case of ASPS, presenting as multiple lung nodules with no other detectable primary site, in a 44-year-old man. A fine needle aspiration of the nodules yielded scattered, discohesive cells, each containing an eccentrically displaced nucleus and prominent nucleolus, on a granular background. Tumor cells with numerous bared nuclei, and occasional sheets of epithelioid cells were also found. Under the cytological diagnosis of an unclassified epithelioid malignant tumor, resection of the lung nodules was performed. The histologic findings were consistent with ASPS, showing positive TFE3-nuclear immunoreactivity. There is limited literature concerning cytological findings associated with pulmonary ASPS: especially in cases where the primary site is unknown. Here, we present a cytological review of pulmonary ASPS, investigating the significance of TFE3 staining in the diagnosis of ASPS.
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Alveolar soft part sarcoma: A case report with emphasis on some unusual cytological features Neelam Sood, Minakshi Gulia Diagnostic Cytopathology.2018; 46(2): 170. CrossRef
Solitary fibrous tumor (SFT) is a benign mesenchymal neoplasm usually occurring in the pleura. Kidney is one of the rarest sites for SFT. We report here on two cases of renal SFT found in 30-year-old and 33-year-old men with review of the literatures. Both cases manifested as well-enhanced solid masses in kidney and radical nephrectomies were done. The tumors consisted of bland-looking spindle cells arranged in short, ill-defined fascicles and storiform pattern with characteristic hemangiopericytoma-like blood vessels. The tumor cells were strongly positive for CD34 and CD99, focally positive for bcl-2, and negative for cytokeratin and human melanoma black-45 on immunohistochemical stainings. Possibility of SFT should be considered in the differential diagnosis of a renal mass which consists of benign-looking spindle cells and hemangiopericytomatous blood vessels.
Immunohistochemical staining for CD34 is essential to confirm the renal solitary fibrous tumor.
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Solitary fibrous tumor located in the sella turcica: A report of two cases and review of the literature XIAO YANG, QINGJUN JIANG, BINGBING YU Oncology Letters.2015; 10(1): 354. CrossRef
Pediatric Renal Solitary Fibrous Tumor William W. Wu, Julia T. Chu, Stephen G. Romansky, Lisa Shane International Journal of Surgical Pathology.2015; 23(1): 34. CrossRef
Mycophenolate mofetil (MMF)-related colitis is one of the common causes of afebrile diarrhea in transplant patients.
Pathologic diagnosis of MMF-related colitis is difficult because microscopic findings of MMF effects resemble those of graft-versus-host disease, inflammatory bowel disease and ischemic colitis. However, if diagnosed, MMF-induced colitis can be markedly improved by discontinuing the drug. A 70-year-old man having a history of transplantation presented with a one month history of afebrile diarrhea.
Colonoscopy revealed patchy erosions. The colonoscopic biopsy specimen showed not only crypt disarray with degenerated crypts and scattered epithelial cell apoptosis, but also stromal inflammatory cell infiltration. A review of his medical records showed that he had been taking immunosuppressive drugs including MMF since his heart transplantation 6 years prior. The histologic findings of colonic mucosa were consistent with MMF-related colitis.
After discontinuing MMF, the diarrhea quickly resolved and has not recurred for 10 months.
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Colitis eosinofílica inducida por micofenolato: reporte de caso Mario Alberto Caviedes-Cleves, Ariel Antonio Arteta-Cueto Iatreia.2023;[Epub] CrossRef
Mycophenolate Mofetil-Induced Colonic Injury Manifesting Endoscopically As Ischemic Colitis Clive J Miranda, Murad H Ali, Muddasir Ayaz, Raheel M Khan, Mayada Ismail Cureus.2023;[Epub] CrossRef
Transformation of the Amino Acid Pool in the Rat Brain under Conditions of Experimental Immunodeficiency N. I. Filina, M. N. Kurbat Neurochemical Journal.2022; 16(2): 174. CrossRef
A Case Series of De Novo Inflammatory Bowel Disease After Kidney Transplantation P. Azevedo, C. Freitas, P. Aguiar, H. Silva, T. Santos, P. Farrajota, M. Almeida, S. Pedroso, L.S. Martins, L. Dias, R. Vizcaíno, A. Castro Henriques, A. Cabrita Transplantation Proceedings.2013; 45(3): 1084. CrossRef
BACKGROUND Recent studies have suggested that implantation site intermediate trophoblasts (ISITs) and chorionic type intermediate trophoblasts (CTITs) show different immunohistochemical findings, and that each type has specific location in placentas. However, we observed that both subtypes are intimately admixed in many areas of the placentas and both types are proliferated around the infarcts. METHODS In order to examine the site specificity in their distribution and the changes of intermediate trophoblasts (ITs), if any, in the pre-eclamptic placentas, quantitative analyses of ISITs and CTITs using p63, CD146, placental alkaline phosphatase, human placental lactogen, and alpha-inhibin were performed in normal and pre-eclamptic placentas containing infarcts. RESULTS In the fetal membranes of both normal and pre-eclamptic placentas, CTITs and ISITs were equally identified, forming distinct layers. ISITs were predominant in the intervillous septum and basal plate, while CTITs were predominant in the subchorionic area. At the margin of infarcts in pre-eclamptic placentas, both subtypes were increased in number, forming distinct layers. CONCLUSIONS The subtypes of ITs do not have site specificity in placentas. Increased number of ITs and zonal distribution around infarcts suggest that CTITs and ISITs have differentiation associated relationship, and the differentiation might be related to the microenvironment of placenta, such as intraplacental oxygen concentration.
BACKGROUND Second opinion diagnosis of outside pathology slides is a common practice for efficient and proper patient management. We analyzed cytology slides from outside hospitals submitted for a second opinion diagnosis to determine whether the second opinion diagnosis had any influence on patient care. METHODS We reviewed 1,153 outside cytology slides referred to Asan Medical Center for second opinions from January, 2007, to December, 2007. All cases were categorized into three groups; no diagnostic discrepancy, minor diagnostic discrepancies (no impact on the management), and major diagnostic discrepancies (significant impact on the management and subsequent follow-up). RESULTS The thyroid was the most common organ system (933 cases, 80.9%). Forty cases (3.6%) belonged to the major diagnostic discrepancy group and 149 cases (12.8%) to the minor discrepancy group. For validation of second opinion diagnoses in major discrepancy cases, subsequent biopsy or surgical resection specimens and clinical information were reviewed, which were available in 29 cases. The second opinion diagnoses resulted in alteration of clinical management in 21 of 29 cases. CONCLUSION For all referred patients, second opinion diagnosis is important and mandatory for appropriate patient care.
Solitary fibrous tumor (SFT) is a rare spindle cell neoplasm that usually arises in the pleura and has been recently reported from unusual locations. We present a case of SFT that occurred in the scrotum. The patient was a 38-year-old man who presented with a painless, left, scrotal mass of five years' duration. Scrotal sonography and pelvic CT scan showed a soft-tissue mass of 11 cm in diameter. The resected tumor measured 11 8 7 cm and was well demarcated from the surrounding soft tissue. The cut surface revealed homogenously grayish-white and gelatinous appearance. No hemorrhage or necrosis was found. Microscopically, the tumor showed hypercellular spindle cell areas intermixed with hypocellular areas lying in a myxoid or collagenous stroma.
The spindle cells had no mitosis or low mitotic figures, and little or no nuclear atypia. They exhibited a variety of growth patterns, including "patternless" pattern, and a prominent vasculature with hemangiopericytic pattern.
Vimentin, CD34, and bcl-2 protein immunoreactivity were observed. Characteristic histologic and immunohistochemical features of this lesion were consistent with SFT. To arrive at a correct diagnosis of this lesion, especially when it occurs in unusual sites, immunohistochemical study including CD34 & bcl-2 protein is required in addition to characteristic histologic features.
Ovarian mature cystic teratoma containing benign prostatic tissue is rare and only 11 cases have been reported in the literature to date.
We report a case of mature cystic teratoma of the ovary containing prostatic tissue. A 23-year-old female patient came to our hospital complaining of irregular menstruation for 3 months. Her menarche had occurred when she was 13 years old. The patient showed no evidence of virilization nor of endocrinopathy. A goose-egg-sized mass was palpable in the left lower abdomen on physical examination. Ultrasonography revealed a cystic ovarian mass with internal echogenecity. Microscopic finding was consistent with that of usual mature cystic teratoma except for a 1.5 cm focus of prostatic and bladder tissues. Prostatic tissue demonstrated strong immunoreactivity for prostatic specific antigen (PSA), prostatic alkaline phosphatase (PAP) and cytokeratin 7. Basal cells of the prostate glands were positive for high molecular weight cytokeratin (34betaE12).
Although ovarian mature cystic teratoma containing prostatic tissue has been reported as a rare occurrence, a careful examination with immunohistochemical staining may increase the detection of prostatic tissue in mature cystic teratoma of the ovary.
Verumontanum mucosal gland hyperplasia (VMGH) is a relatively common benign proliferative lesion which was first described by Gagucas et al in 1995. VMGH is usually found in radical prostatectomy or transurethral resection specimens and rarely in needle biopsy specimens. The histologic feature of VMGH is characterized by well-circumscribed proliferation of small glands and thus VMGH may mimic low grade adenocarcinoma. We report a case of VMGH from a 61-year-old man. The lesion coexisted with prostatic adenocarcinoma on radical prostatectomy specimen. The lesion was a well circumscribed microacinar proliferation which was present between the openings of ejaculatory ducts. The acini consisted of two cell layers with inner secretory cuboidal epithelium and outer basal cell. Typically, the lumen contained many corpora amylacea. Nuclear pleomorphism, prominent nucleolus, or mitotic figure was not identified. Because of small gland proliferation of VMGH, this lesion can be confused with other small gland proliferative lesions, such as low grade adenocarcinoma, atypical adenomatous hyperplasia, basal cell hyperplasia, mesonephric hyperplasia, and nephrogenic adenoma. To avoid misdiagnosis of VMGH as carcinoma, one should be familiar with this lesion.
Prostatic carcinoma is the most commonly diagnosed cancer in the United States in men.
Prostatic carcinoma in Korean men is uncommon and accounts for less than 1% of total cancer: however, the incidence of prostatic carcinoma is continuously increasing. Several clinicopathologic parameters including stage, Gleason score, and serum PSA level have been widely accepted as well established prognostic factors. To study the clinicopathologic features of prostatic carcinoma in Korean men, 58 cases of prostatic carcinoma, which were diagnosed on radical prostatectony specimens at Asan Medical Center from Jan. 1993 to June 1998 (1993; 3 cases, 1994; 3, 1995; 6, 1996; 12, 1997; 24, 1998; 10), were evaluated. The prostatic carcinomas were divided into three groups according to Gleason score. Tumors with Gleason score 6 or lower, 7, and 8 to 10 were categorized as low-grade, intermediate-grade and high-grade tumor, respectively. The overall mean age of the patients was 62.6 years (range, 4 6~76 years); mean age was 65.4, 62.8 and 61.1 in low, intermediate and high-grade tumor, respectively (p>0.05). The overall mean serum PSA level was 38.6 ng/ml (range, 0.3~276.0 ng/ml); mean serum PSA level was 17.0, 29.0 and 60.9 ng/ml in low, intermediate and high-grade tumor, respectively (p=0.002). The mean T stage was 2.3, 2.4 and 3.1 in low, intermediate and high-grade tumor (p=0.001). The percentage of positive resection margin was 33.3, 50.0 and 91.0 % in low, intermediate and high-grade tumor (p=0.001). The overall presence of prostatic intraepithelial neoplasia (PIN) was 79.3 %; percentage of the presence of PIN was 100, 79.2 and 68.2 % in low, intermediate and high-grade tumor (p>0.05). As reported in the literature, our results indicated that Gleason score was a good predictor of stage and prognosis. The higher Gleason score, the more cases were with positive surgical margins, advanced pathologic stage, and high serum PSA level (p<0.05).
There have been some controversies on prognostic significance of lymph node (LN) micrometastasis (MM) in advanced gastric carcinomas (AGCs). The present study aimed at 1) determination of prognostic significance of MM, 2) evaluation of the relationship between MM and clinicopathological parameters, and 3) determination of LN group where MMs were frequently found. We studied 70 cases of AGC without LN metastasis on initial examination. The tumors were examined for location, size, depth of invasion, differentiation, histologic type, lymphatic invasion, and c-erbB-2 expression. To evaluate MM, pancytokeratin immunohistochemistry was performed in all LNs from 70 cases of AGCs. Among 2,203 dissected LNs from 70 patients, 37 (1.6%) LNs from 19 (27.1%) patients revealed MM. Micrometastases were seen in only group 1 and 2 LNs: none had group 3 and 4 LN involvement. The gender, age, tumor size, location of tumor, histologic type, differentiation, depth of invasion, lymphatic invasion, and c-erbB-2 expression were not significantly associated with MM status. The survival time of the MM-positive group (mean: 62 months) was significantly shorter than that of the MM-negative group (mean: 72 months) (p=0.046). The findings of this study indicate that the presence of MM in LNs is an important prognostic factor in AGC patients.
Adenoid basal cell tumor of the prostate is a rare tumorous lesion that can be misdiagnosed as adenocarcinoma of the prostate. The malignant potential of adenoid basal cell tumor remains uncertain due to small number of reported cases. This 66-year-old man presented with symptoms of urinary tract obstruction. Under the impression of benign prostatic hyperplasia, a transurethral resection of the prostate (TURP) was performed. The patient was alive with no evidence of recurrence or metastasis 15 months after TURP.
Microscopically, most of the lesions were composed of nodular collections of small nests of basaloid cells with peripheral palisading, and clusters of tumor cells forming cribriform pattern. Multiple areas of basal cell hyperplasia and atypical basal cell hyperpalsia were also observed. The coexistence of basal cell hyperplasia, atypical basal cell hyperpalsia, and adenoid basal cell tumor with cribriform pattern in this case supports a morphologic continuum from the benign hyperplastic lesion to malignant neoplasia.
BACKGROUND To identify the expression patterns and usefulness of various antibodies in making diagnoses and predicting prognoses, an immunohistochemical study was performed on thymic epithelial tumors (TETs). METHODS Forty-two cases of TETs were reclassified according to the new World Health Organization (WHO) classifications.
CD3, CD5, CD79a, CD99, pan-, high- and low-molecular weight cytokeratins, EMA, vimentin, MIB-1 (Ki67) and p53 immunostaining were carried out. RESULTS There were two, twelve, eight, two, thirteen and one case for type A, AB, B1, B2, B3 and C, respectively.
Combined B1/B2 and B2/B3 were 2 cases each. Fourteen cases (33.3%) had myasthenia gravis. CD99 was immunoreactive mainly in cortically derived lymphocytes, while CD3 and CD5 were immunoreactive in medullary-derived lymphocytes. CD5 immunoreactivity was negative in all thymic epithelial cells, except for one case of type B3. MIB-1 indices were highly expressed in cortical lymphocytes and some thymic epithelial cells, but did not show any correlation with grades. p53 in thymic epithelial cells was expressed in 6 (46%) out of 13 cases of type B3 and one case of type C, and it was negative in all other subtypes. CONCLUSIONS Only p53 was helpful for predicting high grades (B3 and C) (P<0.05). By MIB-1 indices, we could tell how many cortical immature lymphocytes were occupied in TETs, however, grading could not be achieved.
Benign and malignant papillary neoplasms of the breast may be difficult to distinguish in both cytologic and histologic preparations.
To define the cytologic features of benign and malignant papillary lesions, we retrospectively reviewed 18 cases of fine needle aspirates from histologically confirmed cases of papilloma or papillary carcinoma of the breast. This study included 3 intraductal papillary carci nomas, 3 invasive papillary carcinomas, and 12 intraductal papillomas. All cases were evaluated for presence or absence of papillary fragments, bloody background, apocrine metaplasia, macrophages, and degree of cellularity, atypia, and single isolated columnar epithelial cells. Papillary fragments were present in all cases. The background of the smear was bloody in all 6 carcinomas, but in only 7 out of 12 papillomas. Markedly increased cellularity was present in 4 carcinomas(67%) and 7 papillomas(58%). Single cells were present in 5 carcinomas(83%) and 8 papil lomas(67%). The majority of papillomas and papillary carcinomas had mild to moderate atypia, and severe atypia was noted in one case of intraductal papillary carcinoma and one case of invasive papillary carcinoma.
Apocrine metaplasia was absent in all cases of papillary carcinomas, but present in 8 papillomas(67%).
Macrophages were noted in 4 carcinomas and were present in all cases of papillomas. The constellation of severe atypia, bloody background, absence of apocrine metaplasia and/or macrophages were features to favor carcinoma.
Malignant lesions tended to show higher cellularity and more single isolated cells.
The cytologic features mentioned above would be helpful to distinguish benign from malignant papillary lesions of the breast. However, because of overlapping of cytologic features, surgical excision should be warranted in all cases of papillary lesions of the breast to further characterize the tumor.