Medium power: DQ stain
Ductal cells with delicate, vacuolated cytoplasm that is destroyed on smearing resulting in naked nuclei in a foamy proteinaceous background
High power: DQ stain
Ductal cells with delicate, vacuolated cytoplasm.
Note naked nuclei in a foamy proteinaceous background
Low power: pap stain
Cellular smear showing intact breast lobules
Low power: pap stain
Cellular smear showing intact breast lobules and abundant naked nuclei and single cells
Medium power: pap stain
Intact breast lobules with numerous single cells in the background
Medium power: Pap stain
Numerous naked nuclei in a foamy proteinaceous background.
Intact cell with round enlarged nuclei, prominent nucleoli, and abundant vacuolated cytoplasm
High power: Pap stain
Numerous naked nuclei. Intact cell with round enlarged nuclei, prominent nucleoli, and abundant vacuolated cytoplasm
Features
• Smears may be very cellular
• May have intact breast lobules
• Cytoplasm is wispy to vacuolated
• May have apocrine metaplasia with granular cytoplasm
• Enlarged nuclei, may have atypia
• Dense granular chromatin
• Prominent nucleoli
• Numerous naked nuclei as cytoplasm fragile
• May have naked bipolar nuclei
• Cytoplasmic debris
• Proteinaceous material
• Usually difficult to differentiate lactational hyperplasia from a adenoma with lactational change. Usually lesions regress following a year after delivery of the baby; however persisting lesions indicate adenoma. Important to exclude malignancy (high cellularity, dyscohesive cells, pleomorphism, necrosis)
Novotny DB et al. Acta Cytol. 1991 Nov-Dec;35(6):676-86.