Fine needle aspiration cytology of dermatofibrosarcoma protuberans in the breast: a case report

Tsang, Alex K H; Wong, Fiona Chui-Yan; Ng, Ping-Wing; Loke, S. L.; Tse, Gary M.

doi:10.1080/00313020400024733

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…MRI can give information about the deep tissue involvement, especially in patients with large recurrent tumors, whereas, CT has limited value except defining bone involvement. Fine-needle aspiration(FNA) may be useful in establishing a nonspecific pathology in patients with previously treated tumors[7]. However, FNA is not always feasible because obtaining sufficient tissue is difficult for most untreated tumors.…”

Section: Discussionmentioning

confidence: 99%

Reconstructive challenge of dermatofibrosarcoma protuberans in the female breast

et al. 2011

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Dermatofibrosarcoma protuberans is an uncommon locally aggressive malignant neoplasm that most frequently appears in the trunk, followed by the extremities, head, and neck. But occurrence in the breast is extremely rare. We present a case of a 28-year-old woman, who had a history of trauma 5 years previously and excision 1 year before presentation at our clinic. We performed wide excision, together with microscopic and immunohistochemical analysis. No postoperative oncologic treatment was used and she remains disease-free 1 year after the surgery without any tumor recurrence. Here, we report a case of dermatofibrosarcoma protuberans in the female breast and present a detailed discussion of the diagnosis and treatment with reference to available literatures.

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Section: Discussionmentioning

confidence: 99%

Reconstructive challenge of dermatofibrosarcoma protuberans in the female breast

et al. 2011

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“…The presence of bland-looking to mildly atypical epithelial cells, visible clefting and variable cellularity of the stromal fragments, the presence of single and bland columnar to spindle cells of stromal origin in the background is in favour of PT. [23][24][25] However, in malignant PT, the stromal overgrowth may be so prominent that cytological smears may not show any epithelium at all, making it difficult, if not impossible, to distinguish these lesions from pure spindle cell mesenchymal tumours. 26 Another possibility for the differential diagnosis is the desmoplastic stroma of ductal carcinoma, but the cytological differentiation would not be possible.…”

Section: Discussionmentioning

confidence: 99%

Fine-needle aspiration cytology of metaplastic carcinoma of the breast

et al. 2006

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Background: Metaplastic carcinoma of the breast encompasses a heterogeneous group of tumours with variable components of sarcomatoid, squamous or poorly differentiated carcinomas. Aim: To review a series of 19 cytological preparations of metaplastic carcinomas to assess diagnostic cytological features. Methods: 17 cases of fine-needle aspirates of histologically proven metaplastic carcinomas (4 monophasic spindle cell carcinomas, 4 squamous cell carcinomas and 11 biphasic tumours) were reviewed, with an emphasis on the presence of poorly differentiated carcinoma, squamous cell carcinoma, atypical spindle cells, benign stromal fragments and necrosis. Results: All cases were diagnosed as malignant, with 68% of cases showing moderate to high cellularity, and 47% showing necrosis. If the tumours were analysed according to the constituting components histologically, 7, 15 and 8 cases, respectively, possess poorly differentiated carcinoma cells, sarcomatoid malignant cells and squamous carcinoma cells, whereas these components were cytologically identified in 11, 10 and 7 cases, respectively. Dual tumour populations were identified in only 5 of the 11 biphasic carcinomas in the cytological preparations; and the stromal material was cytologically identified in the only case with chondroid stroma. Conclusions: Identification of metaplastic carcinoma in cytology remains problematic. There seems to be morphological overlap between various components. The identification of dual components, unequivocal squamous carcinoma cells and chondroid stroma is helpful for diagnosis, but it is uncommon. The presence of poorly differentiated carcinoma cells with a suggestion of focal spindle morphology is another clue to the suggestion of metaplastic carcinoma.

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“…The cutaneous derivation of DFSP helps in differentiating it from breast sarcoma. [21][22][23][24] Other new markers that have been identified and can be useful in the differential diagnosis include apolipoprotein D, nestin, stromelysin, and CD163. 8,22 Fine needle aspiration biopsy has a low diagnostic accuracy for low to intermediate grade mesenchymal tumors and core biopsy is preferred to get an accurate diagnosis with the help of ancillary studies.…”

Section: Discussionmentioning

confidence: 99%

“…8,22 Fine needle aspiration biopsy has a low diagnostic accuracy for low to intermediate grade mesenchymal tumors and core biopsy is preferred to get an accurate diagnosis with the help of ancillary studies. 23,24 The differential diagnosis of the spindle cell lesions of the breast is challenging as these are uncommon entities. The most important way to identify these tumors is to recognize the pattern and predominant cell type, presence of mitosis, cytologic atypia and necrosis to differentiate benign from malignant process.…”

Section: Discussionmentioning

confidence: 99%

DFSP of the Breast: Histomorphological, Immunohistochemical, and Molecular Features of a Rare Case in an Unusual Location

Laharwani

Prakash²,

Walley³

et al. 2021

Applied Immunohistochemistry &Amp; Molecular Morphology

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We present a case of a 21-year-old female with a vague nontender mass in the lower inner quadrant of the left breast discovered incidentally on chest imaging following trauma. A breast ultrasound demonstrated an 8×6×8 mm irregular hyperechoic mass at the 7 o'clock position of the left breast, 9 cm from the nipple. The mass was graded Breast Imaging Reporting and Data System (BI-RADS) category 4 (suspicious finding). An ultrasound-guided biopsy of the mass showed a proliferation of monotonous spindled cells in a storiform pattern with tapered nuclei with infiltration into the adipose tissue. No normal breast elements were identified in the biopsy. Myofibroblastoma was the first differential diagnosis; however, the characteristic infiltrative pattern of the tumor mandated additional tests including fluorescence in situ hybridization to rule out a dermatofibrosarcoma protruberance (DFSP). Immunohistochemical staining showed positive staining for CD34, which can be positive in myofibroblastoma also. However, fluorescence in situ hybridization demonstrated a platelet-derived growth factor B (22q13.1) gene rearrangement confirming a diagnosis of DFSP. The patient underwent a wide local excision of the DFSP for definitive treatment. She is doing well with no recurrence reported so far, after 15 months of follow-up. Conventional DFSP does not metastasize but is prone to recurrence making wide margins imperative for definitive treatment.

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Fine needle aspiration cytology of dermatofibrosarcoma protuberans in the breast: a case report

Cited by 7 publications

References 15 publications

Reconstructive challenge of dermatofibrosarcoma protuberans in the female breast

Reconstructive challenge of dermatofibrosarcoma protuberans in the female breast

Fine-needle aspiration cytology of metaplastic carcinoma of the breast

DFSP of the Breast: Histomorphological, Immunohistochemical, and Molecular Features of a Rare Case in an Unusual Location

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