Breast FNAC - Probabilistic approach

Breast FNA is more sensitive and specific for malignant neoplasms than for borderline or benign lesions. A diagnostic approach based on the probability of identifying malignancy in a breast is therefore more clinically appropriate. This has been termed the probabilistic approach to the diagnosis of carcinoma.

Five diagnostic categories are defined

1) Positive for carcinoma

all four of the following must met:

Cellular dyshesion
Cytological atypia
Single cell population
Hypercellularity

2)Suspicious for carcinoma

When any three of the above four features are present

3)Epithelial proliferative lesion with atypia

when the specimen in cellular with many epithelial cells and when epithelial cells present in groups and show significant crowding and overlapping and/or specimen shows one other feature of malignancy out of above four.

4) Epithelial proliferative lesion without atypia

when specimen is cellular with many epithelial cell and the epithelial cells in groups show no or mild crowding and overlapping, with obvious myoepithelial cells present and no other features of carcinoma.

5) Unremarkable

when none of the four features of malignancy is present

Spot it 4: Answer

Hi friends, this picture is of embryoid body from polyembryoma, a type of mixed germ cell tumor in which embryonal and yolk sac component combine to form structure resembling developing embryo (embryoid body)

Spot it-4

Image from Ovary

Spot it-3: Answer

Both are benign,

First figure shows radiation change, enlarged cells with low N:C ratio and smudgy chromatin is typical of radiation change

Second figure shows degenerative change, as evident by karyorrhexis

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Spot it-3: benigh or malignant

This two are bronchial brush PAP stained preparation from different cases, what do you think are they benign or malignant? give your comments separately for both images.

Correct answer will be posted after 2 days

Spot it 1 and 2- answer

Spot it 2: these are charcot layden crystals in sputum, formed due to disintegration of eosinophilic granules , they can be seen in allergic pulmonary conditions including asthma



Spot It- This are sputum images showing curschmann spiral , they can be considered as mucus casts formed in bronchioles due to obstruction, can be seen in asthma, chronic smokers and other causes of obstruction