Papilloma with myoepithelial hyperplasia in breast: a rare cytology diagnosis

Papillary neoplasm of breast with myoepithelial hyperplasia is a rare entity. Interpretation of papillary lesions of the breast remains a challenging task because of the wide morphologic spectrum encountered in benign, atypical and malignant subtypes. We present an interesting and rare case of a 37 year old female reported to surgical out-patient department with complaints of lump in right breast for 2 years. Mammogram diagnosis was Intraductal malignancy with Birads score V. Fine needle aspiration cytology of the lesion did not reveal features of malignancy and a diagnosis of papillary neoplasm with myoepithelial hyperplasia was rendered. Excision biopsy of the lump showed multiple papillomatosis with marked myoepithelial hyperplasia. The diagnosis of this entity by Fine needle aspiration cytology is crucial as it is a rare diagnosis and it can mimic malignancy, radiologically and clinically. It is imperative to rule out malignancy in such cases as it changes the treatment plan dramatically