{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T11:48:38Z","timestamp":1775908118149,"version":"3.50.1"},"reference-count":52,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,10,25]],"date-time":"2013-10-25T00:00:00Z","timestamp":1382659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:p>Adequately cellular and representative fine\u2010needle aspirates (FNAs) of breast have a high diagnostic accuracy. There is, however, a recognized category designated as \u201cgray zone\u201d where a definitive diagnosis cannot be reached. We reviewed our experience in this category to identify useful diagnostic parameters.<\/jats:p><jats:p>Twenty\u2010four such FNAs with surgical follow\u2010up were retrieved from AUBMC files (2003\u20132009). Cytology slides were reviewed blindly.<\/jats:p><jats:p>All cases were females, 29\u201373 years. There were three erroneous and 21 inconclusive diagnoses. The majority (15) was invasive adenocarcinomas: two cribriform, four tubular, one lobular, and eight not otherwise specified. The remaining cases were papillary and fibroepithelial tumors (three each), ductal carcinoma in situ, cribriform (two), and one adenomyoepithelioma (AME). Useful diagnostic features included: (1) Biphasic cell population with focal nuclear atypia and intranuclear and cytoplasmic vacuolar inclusions (AME). (2) Complex clusters of epithelial cells with cribriform architecture (cribriform carcinoma). (3) Rigid tubular epithelial structures with abrupt change in diameter, ending in pointed tips with abnormal branching (tubular carcinoma). (4) Cellular stromal fragments (fibroepithelial tumors). (5) Papillary fibrovascular cores, columnar cells, and three\u2010dimensional papillary epithelial fragments (papillary tumors). Myoepithelial cells classically described in benign aspirates were not always a discriminatory factor.<\/jats:p><jats:p>The \u201cgray zone\u201d in breast FNA is usually due to overlapping cytologic features of some benign and malignant lesions. Useful distinguishing cytologic features are described. Diagn. Cytopathol 2014;42:405\u2013415. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/dc.23054","type":"journal-article","created":{"date-parts":[[2013,10,25]],"date-time":"2013-10-25T18:27:42Z","timestamp":1382725662000},"page":"405-415","source":"Crossref","is-referenced-by-count":7,"title":["Inconclusive or erroneous fine\u2010needle aspirates of breast with adequate and representative material: A cytologic\/histologic study"],"prefix":"10.1002","volume":"42","author":[{"given":"Nina S.","family":"Shabb","sequence":"first","affiliation":[{"name":"Department of Pathology American University of Beirut Medical Center Beirut Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fouad I.","family":"Boulos","sequence":"additional","affiliation":[{"name":"Department of Pathology American University of Beirut Medical Center Beirut Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaher","family":"Chakhachiro","sequence":"additional","affiliation":[{"name":"Department of Pathology American University of Beirut Medical Center Beirut Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaber","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of Surgery American University of Beirut Medical Center Beirut Lebanon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fadi W.","family":"Abdul\u2010Karim","sequence":"additional","affiliation":[{"name":"Department of Pathology Cleveland Clinic Lerner College of Medicine Cleveland Clinic Ohio"},{"name":"Department of Anatomic Pathology Cleveland Clinic Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,10,25]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"crossref","unstructured":"National Cancer Institute Fine\u2010Needle Aspiration of Breast Workshop Subcommittees. 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