Spindle cell lesions of the breast – An approach to diagnosis

Tay, Timothy Kwang Yong; Tan, Puay Hoon

doi:10.1053/j.semdp.2017.05.012

Cited by 23 publications

(39 citation statements)

References 57 publications

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“…On IHC, fibromatosis stains positively for β-catenin, SMA, and vimentin; variably for desmin and estrogen receptor (ER), and negatively for CD34, p63, and pankeratins. Patients who have familial adenomatous polyposis demonstrate mutations of the APC gene, while sporadic cases may show mutations of the CTNNB1 gene [1, 8, 13]. …”

Section: Bland Spindle Cell Lesionsmentioning

confidence: 99%

“…Myofibroblastoma presents as a mobile and painless breast mass that, on radiology, is seen as a well-circumscribed mass lacking calcification. Myofibroblastoma is managed by excision [1, 8, 10, 15]. …”

Section: Bland Spindle Cell Lesionsmentioning

confidence: 99%

“…These lesions may range from benign reactive or inflammatory lesions to high-grade malignancies [1-3]. It is important to note that while mesenchymal lesions of the breast have a spindle morphology, lesions derived from the epithelium, and myoepithelium also can show spindle cells [1]. …”

Section: Introductionmentioning

confidence: 99%

“…Other components such as bony or cartilaginous differentiation, and chronic inflammatory cells should also be looked for. However, bland-appearing spindle cells may still be malignant, for example, fibromatosis-like metaplastic carcinoma of the breast [1, 4, 5] (Table 1). …”

Section: Introductionmentioning

confidence: 99%

“…Bcl-2 immunostaining is positive in phyllodes tumor and PASH, and negative in metaplastic carcinoma and fibromatosis. Myofibroblastoma demonstrates variable Bcl-2 staining [1, 2, 8]. The specific marker or markers utilized on a cell block should be determined by the cytological findings, but a panel including SMA, P63, S100, CD34, B-catenin, and a pankeratin including CAM5.2 and AE1/AE3 should be considered as a starting point.…”

Section: Introductionmentioning

confidence: 99%

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Spindle Cell Lesions of the Breast on Fine-Needle Aspiration Biopsy: A Miscellany of Masses

Michelow

Field

2019

Acta Cytologica

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A variety of primary breast and metastatic lesions to the breast can present with spindle cell cytomorphology. These lesions may range from benign reactive or inflammatory lesions to high-grade malignancies. Spindle cell lesions of the breast are not often seen on fine-needle aspiration biopsy (FNAB) but need to be correctly managed when they are encountered. While mesenchymal lesions of the breast have a spindle morphology, lesions derived from the epithelium and myoepithelium can be spindled as well. By assessing if the lesion comprises spindle cells only or if other components such as epithelial cells are apparent and then determining whether the spindle cells appear bland or pleomorphic, together with close clinicoradiologic correlation and prudent use of ancillary tests, a variety of lesions can be diagnosed on FNAB. However, core needle biopsy or excision biopsy may be required in some patients. The cytomorphology, ancillary studies, and clinicoradiologic findings of a range of spindle cell lesions of the breast are further discussed.

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Section: Bland Spindle Cell Lesionsmentioning

confidence: 99%

Section: Bland Spindle Cell Lesionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spindle Cell Lesions of the Breast on Fine-Needle Aspiration Biopsy: A Miscellany of Masses

Michelow

Field

2019

Acta Cytologica

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Mammary mesenchymal and fibroepithelial lesions: An illustrated cytomorphologic update with differential diagnoses

Khattab

Rowe

Booth

et al. 2019

Diagnostic Cytopathology

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The Uniform Approach to Breast Fine Needle Aspiration Biopsy was put forward by a learned group of breast physicians in 1997. This landmark manuscript focused predominantly on diagnosis and reporting of mammary epithelial lesions. Today, most American practitioners turn initially to core biopsy rather than aspiration biopsy for the first line diagnosis of solid breast lesions; however, recent efforts from the International Academy of Cytology have produced a system called the Standardized Reporting of Breast Fine Needle Aspiration Biopsy Cytology (colloquially labeled in 2017 as the “Yokohama System”), suggesting a new interest in breast fine needle aspiration (FNA), especially in resource limited settings or clinical practice settings with experienced breast cytopathologists. Fibroepithelial lesions of the breast comprise a heterogeneous group of biphasic tumors with epithelial and stromal elements. Mesenchymal lesions of the breast include a variety of neoplasms of fibroblastic, myofibroblastic, endothelial, neural, adipocytic, muscular, and osteo‐cartilaginous derivations. The cytology of mesenchymal breast lesions is infrequently described in the literature and is mainly limited to case reports and small series. This illustrated review highlights the cytologic features of fibroepithelial and mesenchymal mammary proliferations and discusses differential diagnoses and histomorphologic correlates.

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