1. Educational case 1 Dr JD Hemming Queen Elizabeth Hospital Gateshead

2. Educational Case 1 Female age 64. Presented to Breast Screening with irregular density in right lower half of her breast. FNAC.

7. Educational Case 1 What is your diagnosis? Continue to find diagnosis

8. Educational case 1 The cellular aspirate contained sheets of cohesive epithelial cells with atypical architecture and showing mild nuclear atypia. Many of the sheets contained well defined small hyaline globules staining orange with PAP stain and bright magenta with MGG. Myoepithelial cells were not a feature. The aspirate was reported as C3, ?adenoid cystic carcinoma, ?spherulosis,. Subsequent core biopsy and excision confirmed an adenoid cystic carcinoma (see histology slide). Adenoid cystic carcinomas are malignancies of low aggressive potential histologically and cytologically similar to their salivary gland counterpart. The cytologist needs to be aware of its existence. The cytological appearance is identical to that of adenoid cystic carcinoma of salivary gland. Hyaline globules can also be associated with benign breast disease, 'collagenous spherulosis' Reference: Fine Needle Aspiration Cytology, Orell,Sterrett and Whitaker.