Pleomorphic lobular carcinoma of the breast: a comparison of cytopathological features with other lobular carcinoma variants

OBJECTIVE

Pleomorphic lobular carcinoma (PLC) is a subtype of breast cancer with unique morphological features, but it remains controversial whether PLC should be considered an independent disease entity. The aim of this study was to illustrate cytopathological characteristics of PLC in comparison with other lobular carcinoma variants.

METHODS

We investigated clinicopathological features of PLC (n = 11) compared with those of other variants of invasive lobular carcinoma (ILC, non-PLC) (n = 32). Histological variants of the non-PLC group consisted of classic (n = 25), solid (n = 2), alveolar (n = 1) and a tubulolobular type (n = 4). A review of cytological reports and fine needle aspiration (FNA) smear samples was performed for the PLC (n = 9) and non-PLC (n = 27) groups.

RESULTS

Patients with PLC were older, and had a higher nuclear grade and a higher incidence of axillary lymph node metastasis and triple negative phenotype than non-PLC patients (P = 0.007, P < 0.001, P = 0.02 and P < 0.001, respectively). Cytological findings in PLC included medium- to large-sized nuclei, prominent nucleoli, a moderate-to-severe degree of pleomorphism, apocrine change and background necrosis, none of which were evident in the smears of the non-PLC group (P < 0.001, P = 0.002, P < 0.001, P < 0.001, and P = 0.03, respectively). Despite these differences, patients with PLC and non-PLC showed similar clinical outcomes in our follow-up period.

CONCLUSIONS

Based on our results, a cytological diagnosis of PLC should be proposed if there are moderate- to large-sized nuclei, prominent nucleoli, a moderate-to severe degree of nuclear pleomorphism, apocrine change and necrosis in the background in FNA biopsy samples.

Macrophage-activating factor for cytotoxicity produced by a human T-cell hybridoma

Human MAF-C (macrophage-activation factor for cytotoxicity)-producing hybridoma H2-E3-5 was prepared by somatic cell fusion of PHA-activated peripheral blood lymphocytes with emetine/actinomycin D-treated cloned human acute lymphatic leukemia cells (CEM). The following activities were assayed: (1) macrophage-migration-inhibitory factor (MIF), (2) macrophage-activation factor for glucose consumption (MAF-G), (3) macrophage-activation factor for O2-formation (MAF-O), and (4) macrophage-activation factor for cytotoxicity (MAF-C). After anion-exchange chromatography, MAF-C activity could be distinguished from MIF and MAF-O activities. It is shown that MAF-C is not the same as MAF-G from the culture supernatants of CEM 11, a parent cell line of H2-E3-5. Furthermore, MAF-C from H2-E3-5 culture supernatants activated differentiated macrophages but not monocytes.