A Rare Case of Epithelioid Myofibroblastoma of Breast Mimicking Lobular Carcinoma on Trucut Biopsy: a Diagnostic Pitfall and Literature Review

Talwar, Amrita; Jain, Swasti; Ahuja, Arvind; Paliwal, Purnima

doi:10.1007/s13193-021-01294-9

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…Other lesions at risk for overdiagnosis of malignancy in breast pathology, particularly on core needle biopsy (CNB) specimens, include those that lack the typical epithelial‐myoepithelial glandular bi‐layer, e.g. pleomorphic adenoma and sclerosed adenomyoepithelioma that may be misdiagnosed as metaplastic breast carcinoma (MBC), 6 the epithelioid variant of myofibroblastoma, composed of dyscohesive oestrogen receptor (ER)‐positive epithelioid cells, which resembles invasive lobular carcinoma (ILC), 7 fat necrosis with a florid histiocytic reaction that may be mistaken for apocrine ILC, 8 and Toker cell hyperplasia of the nipple that may be misdiagnosed as Paget's disease of the nipple. Here we describe some entities that may result in overdiagnosis of malignancy based on the histological findings.…”

Section: Entities That May Results In Overdiagnosis Of Malignancymentioning

confidence: 99%

Pitfalls in breast pathology

2022

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Accurate pathological diagnosis is the cornerstone of optimal clinical management for patients with breast disease. As non-operative diagnosis has now become the standard of care, histopathologists encounter the daily challenge of making definitive diagnoses on limited breast core needle biopsy (CNB) material. CNB samples are carefully evaluated using microscopic examination of haematoxylin and eosin (H&E)-stained slides and supportive immunohistochemistry (IHC), providing the necessary information to inform the next steps in the patient care pathway. Some entities may be difficult to distinguish on small tissue samples, and if there is uncertainty a diagnostic excision biopsy should be recommended. This review discusses (1) benign breast lesions that may mimic malignancy, (2) malignant conditions that may be misinterpreted as benign, (3) malignant conditions that may be incorrectly diagnosed as primary breast carcinoma, and (4) some IHC pitfalls. The aim of the review is to raise awareness of potential pitfalls in the interpretation of breast lesions that may lead to underdiagnosis, overdiagnosis, or incorrect classification of malignancy with potential adverse outcomes for individual patients.

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Section: Entities That May Results In Overdiagnosis Of Malignancymentioning

confidence: 99%

Pitfalls in breast pathology

2022

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“…Modified radical mastectomy has also been reported in the literature as a treatment for MFB. One case misinterpreted a breast lump as invasive lobular carcinoma due to histological findings and IHC showing strong positivity of estrogen and progesterone receptors (ER/PR+) [ 15 ]. The patient subsequently underwent a modified radical mastectomy for treatment of the presumed invasive lobular carcinoma; however, upon gross examination and large IHC profiling, the diagnosis of MFB was obtained [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…One case misinterpreted a breast lump as invasive lobular carcinoma due to histological findings and IHC showing strong positivity of estrogen and progesterone receptors (ER/PR+) [ 15 ]. The patient subsequently underwent a modified radical mastectomy for treatment of the presumed invasive lobular carcinoma; however, upon gross examination and large IHC profiling, the diagnosis of MFB was obtained [ 15 ]. Out of the 38 cases reviewed in our study, only one case documented a diagnosis of MFB with a negative ER seen on the IHC panel.…”

Section: Discussionmentioning

confidence: 99%

An Immunohistochemical Anomaly: A Case Report and Systematic Review of Myofibroblastoma of the Breast

Kaki,

Klein,

Singh

et al. 2023

Cureus

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Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are treated by surgical excision. The diagnosis of MFB is made through immunohistochemical (IHC) analysis, with the most common biomarkers being CD34+, desmin+, smooth muscle actin+, and vimentin+. In this article, we describe a case of an MFB in a premenopausal female with variance from classic IHC findings. We also performed a systemic review of the MFB of the breast. The systemic review compiles the most common IHC findings of MFB, patient demographics, treatment methods, lesion size, and the presence or absence of pain associated with the lesion. As MFB can share many features with other breast lesions, including potentially malignant ones, this article sought to underline the most common IHC findings and characteristics of MFB to aid in the proper diagnosis of MFB.

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A Rare Case of Epithelioid Myofibroblastoma of Breast Mimicking Lobular Carcinoma on Trucut Biopsy: a Diagnostic Pitfall and Literature Review

Cited by 2 publications

References 10 publications

Pitfalls in breast pathology

Pitfalls in breast pathology

An Immunohistochemical Anomaly: A Case Report and Systematic Review of Myofibroblastoma of the Breast

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