Postoperative spindle cell nodule of the breast: Pseudosarcomatous myofibroblastic proliferation following endo‐surgery

Garijo, M. Francisca; Val-Bernal, J. Fernando; Vega, Alfonso; Val, Daniel

doi:10.1111/j.1440-1827.2008.02312.x

Cited by 20 publications

(7 citation statements)

References 19 publications

(30 reference statements)

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“…Because of their high cellularity and proliferative activity, these lesions can be worrisome on cytology. Knowledge of the clinical circumstances, namely prior manipulation and rapid unexplained growth, paired with the absence of significant hyperchromasia and nuclear irregularity and a conspicuous inflammatory and hemosiderotic background can assist the pathologist in rendering a correct benign diagnosis [117]. We reemphasize the extreme caution pathologists should exercise when dealing with mammary spindle-cell lesions.…”

Section: Benign and Malignant Spindle-cell Lesionsmentioning

confidence: 99%

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

2013

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Objective: To review our experience and the literature on inconclusive/erroneous fine-needle aspirates (FNAs) of breast with the focus on the ‘true gray zone'. To describe the cytology, differential diagnosis, pitfalls and limitations of common and rare lesions. Study Design: We conducted a literature search focusing on breast FNAs with statistical data of C3 and C4 categories including false-positive and false-negative cases. Similar data from 2003 to 2009 was obtained from our institution. Results: C3 and C4 categories account for 3-17% of breast FNAs. Contributing factors are technical difficulties, inexperienced pathologists interpreting FNAs of breast and overlap of cytologic features of certain benign and malignant conditions; this last, ‘true gray zone' accounts for 2% of cases. Fibroadenoma, proliferative breast lesions, gynecomastia, infiltrating and in situ low-grade adenocarcinomas and tubular, cribriform, lobular and mucinous carcinomas are the most common problematic lesions. Granular cell tumor, adenomyoepithelioma, pregnancy-related lesions, fat necrosis, inflammatory and radiation changes, adenoid cystic carcinoma, spindle-cell lesions and Phyllodes tumor are less common. Conclusion: Inconclusive/erroneous FNAs of breast due to the ‘true gray zone' are rare. Most are due to the overlapping cytologic features of some benign and malignant conditions. Practical features that may help arrive at the correct diagnoses are elucidated.

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Section: Benign and Malignant Spindle-cell Lesionsmentioning

confidence: 99%

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

2013

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“…Others may not have any known relevant history, and scar should always be borne in mind when analysing a breast SCL. Recent scar may present as a proliferation of very active fibroblasts with mitotic activity that, in its most florid phase, can be designated as a postoperative spindle cell nodule 33 . Knowledge of any relevant clinical history and a search for accompanying change, e.g.…”

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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“…Fasciitis-like proliferations in visceral organs have sometimes been termed ''postoperative spindle cell nodules'' but are recognized to occur without prior surgery [2,3]. Such lesions have been reported in the urinary tract, prostate, and breast but not the gallbladder.…”

Section: Discussionmentioning

confidence: 99%

Cholecystitis and Cholelithiasis Associated with an Intramural Fasciitis-Like Proliferation and Osseous Metaplasia

Rege

Vargas

2011

Pediatr Dev Pathol

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Fasciitis-like proliferations are said to be uncommon in the viscera; a fasciitis-like pattern of gallbladder injury may not be rare, but to our knowledge it has not been explicitly reported as such in any age group. Osseous metaplasia, or heterotopic bone, in the gallbladder is rare and has not to our knowledge been reported in a pediatric patient. We report a 7-year-old boy with sickle cell disease who presented with right upper quadrant abdominal pain. An ultrasonograph demonstrated a dilated common bile duct with sludge and stones. A cholecystectomy was performed. Grossly the gallbladder showed numerous pigmented choleliths, and histologically there was cholecystitis with a fasciitis-like fibrous proliferation containing scattered osteoclast-like giant cells and an area of osseous metaplasia. This report, describing a pattern that could be termed "cholecystitis ossificans," expands the histologic spectrum of chronic cholecystitis, a common disease with a poorly understood pathogenesis.

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Postoperative spindle cell nodule of the breast: Pseudosarcomatous myofibroblastic proliferation following endo‐surgery

Cited by 20 publications

References 19 publications

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

Indeterminate and Erroneous Fine-Needle Aspirates of Breast with Focus on the ‘True Gray Zone': A Review

Pitfalls in breast pathology

Cholecystitis and Cholelithiasis Associated with an Intramural Fasciitis-Like Proliferation and Osseous Metaplasia

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