Mammary Myofibroblastoma With Leiomyomatous Differentiation

Thomas, Teresa M. M.; Myint, Aung; Mak, Colin K. L.; Chan, John K. C.

doi:10.1093/ajcp/107.1.52

Cited by 39 publications

(19 citation statements)

References 7 publications

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“…These cells are considered uncommitted stromal cells and, as such, are endowed with plasticity [42,48,60,67] to undergo multilineage proliferation along different pathways leading to heterogeneous pathological conditions such as SFT and SCL of soft tissues [60], and fibroadenomas, phylloides tumors and pseudoangiomatous hyperplasia in the breast [48]. Another speculative observation suggesting the role of the mammary stroma in tumorigenesis of BSST as a whole is given by the evidence that both fibroblastic and myofibroblastic tumors may contain a variable admixture of two or three lines of differentiation within the same neoplasm such as fibroblastic plus adipocytic in SCL/SCL-like tumor [39,42,65], and SFT [24,44,50,61] or fibroblastic plus myofibroblastic (in most cases of MFBs), myofibroblastic plus adipocytic [43] and, as reported elsewhere, myofibroblastic plus smooth muscle [20,64] or cartilaginous [20,33,34,68] or osseous [33] in rare cases of MFB. This is in accordance with the well-known multidirectional differentiation ability of the mammary stromal cells that may undergo changes in their phenotype in several other breast benign pathological conditions, typical examples of which include fibroadenoma with leiomyomatous component [23,64], phylloides tumors with fat, bone, cartilage or even skeletal muscle metaplasia [54,63], hamartomas with adipocytic, smooth muscle, and chondroid stromal components [15,38,54], and some breast lesions labeled as "mesenchymoma" in which even three lines of differentiation (e.g., myo-chondro-lipoma) can be documented [4,32].…”

Section: Discussionmentioning

confidence: 73%

Spindle cell lipoma-like tumor, solitary fibrous tumor and myofibroblastoma of the breast: a clinico-pathological analysis of 13 cases in favor of a unifying histogenetic concept

Magro

Bisceglia

Michal³

et al. 2002

Virchows Arch

180

165

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We reviewed the clinico-pathological features of a series of 13 cases of benign spindle stromal tumors (BSSTs) of the breast relating to a basic common theme consisting of a well-circumscribed proliferation of vimentin+/CD34+/BCL-2+/CD99+ spindly to oval-epithelioid cells, variably arranged in haphazard to short fascicular growth pattern, with interspersed thick or thin collagen bands. Morphological variations included atypical mono- or multi-nucleated cells in five cases and a mature lipomatous tumor component, varying from focal to prominent, in eight cases. Based on morphological and immunophenotypical features, a distinction was made between two main subtypes of these tumors--fibroblastic and myofibroblastic. The former subtype included two cases respectively represented by a typical solitary fibrous tumor (SFT) and a neoplasm labeled "spindle-cell lipoma (SCL)-like tumor", closely reminiscent of soft tissue SCL. Both tumors had cells with fibroblastic-like appearance, haphazardly arranged and immunoreactive for vimentin, CD34, BCL-2, and CD99. The latter subtype, comprised nine cases exhibiting evidence of myofibroblastic differentiation (desmin and alpha-smooth muscle actin) which were classified as myofibroblastomas (MFBs). The remaining two cases were defined as "mixed BSSTs", having typical features of diverse neoplasms, respectively represented by a case of MFB with focal SFT and pleomorphic/SCL-like areas, and SFT with focal MFB-like component. The common basic morpho-immunophenotypical features, the possibility that both fibroblastic and myofibroblastic tumors may contain an additional mature lipomatous component, and the existence of hybrid stages (mixed BSSTs) strongly support the view that such tumors belong to the same category of lesions. We postulate that the precursor of all these neoplasms is the vimentin+/CD34+ cells of the mammary stroma, the well-known inherent plasticity of which to differentiate toward several mesenchymal lines, provides the explanation for the phenotypic heterogeneity of these neoplasms. Accordingly, the encompassing term "benign spindle stromal tumors of the breast" is advocated for such tumors.

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Section: Discussionmentioning

confidence: 73%

Spindle cell lipoma-like tumor, solitary fibrous tumor and myofibroblastoma of the breast: a clinico-pathological analysis of 13 cases in favor of a unifying histogenetic concept

Magro

Bisceglia

Michal³

et al. 2002

Virchows Arch

180

165

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“…The myofibroblastic differentiation observed in MFB is explained if we assume that the mammary stromal cell is capable of altering its phenotype along different mesenchymal lines of differentiation. This is demonstrated by the variable coexistence of fibroblasts, myofibroblasts, mature smooth muscle cells, adipocytes and even occasional foci of mature cartilaginous and osseous tissues in the same case of MFB of breast [2,8,9,11,22,28,29,33]. Moreover, a similar multipotential differentiation of the mammary stroma is a well known occurrence in several breast pathologic conditions such as fibroadenoma with myofibroblastic [24] or leiomyomatous component [22], phyllodes tumour, hamartoma and so-called benign mesenchymoma [22].…”

Section: Discussionmentioning

confidence: 99%

Lipomatous myofibroblastoma: a potential diagnostic pitfall in the spectrum of the spindle cell lesions of the breast

et al. 2000

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We report on two cases of myofibroblastoma (MFB) of the breast comprised predominantly of a mature fatty component, representing approximately three quarters of the entire tumour area. Both tumours consisted of a well-circumscribed lipomatous tumour mass containing dispersed nodular or irregularly shaped spindled cellular areas. The fatty component was represented exclusively by mature adipocytes, uniform in size and shape, lacking nuclear pleomorphism. The cellular areas contained spindly to oval cells with morphological and immunophenotypical features typical of MFB. The two components were so intimately admixed that a finger-like infiltrating growth pattern was apparent. The cases reported here as "lipomatous MFB" aim to clarify further the morphological spectrum of MFB of the breast. Lipomatous MFB may potentially mimic other benign or aggressive tumour-like lesions or even bland-looking malignant spindle cell tumours such as fibromatosis, nodular fasciitis, spindle cell lipoma, spindle cell liposarcoma, spindle cell variant of metaplastic carcinoma, spindle cell malignant myoepithelioma, and low-grade fibrosarcoma/malignant fibrous histiocytoma. The histogenesis of the present bimorphic mesenchymal tumours could be explained as the result of a dual, myofibroblastic and lipomatous, differentiation from a common pluripotential mesenchymal precursor cell, probably represented by the vimentin+/CD34+ fibroblast of the mammary stroma.

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“…It is found more frequently in the male breast. [37][38][39][40] The tumor is comprised of fascicles of uniform spindle cells separated by bands of hyalinized collagen and edematous areas. [37][38][39][40][41] Mitoses are rare.…”

Section: Discussionmentioning

confidence: 99%

Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence

Gobbi¹,

Simpson²,

Borowsky³

et al. 1999

Cancer

180

192

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Mammary Myofibroblastoma With Leiomyomatous Differentiation

Cited by 39 publications

References 7 publications

Spindle cell lipoma-like tumor, solitary fibrous tumor and myofibroblastoma of the breast: a clinico-pathological analysis of 13 cases in favor of a unifying histogenetic concept

Spindle cell lipoma-like tumor, solitary fibrous tumor and myofibroblastoma of the breast: a clinico-pathological analysis of 13 cases in favor of a unifying histogenetic concept

Lipomatous myofibroblastoma: a potential diagnostic pitfall in the spectrum of the spindle cell lesions of the breast

Metaplastic breast tumors with a dominant fibromatosis-like phenotype have a high risk of local recurrence

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