periductal stromal tumor breast pathology outlines

The red arrow shown in panels (A, B) demonstrated that the margin of the mass was obscured; however, the red arrow area in panels (C, D) showed unshielded margin of the mass, which was more obvious compared with that in Figure3A. [1], There have been proposals for several grading systems, but the use of the three-tiered system, including benign, borderline, and malignant phyllodes tumor, is preferred because this approach leads to greater certainty at the ends of the spectrum of these fibroepithelial lesions. No use, distribution or reproduction is permitted which does not comply with these terms. Studies demonstrate that p53, Ki67, CD117, EGFR, p16, and VEGF (being the lowest in benign phyllodes tumors and the highest in malignant phyllodes tumors) are associated with histologic grades of phyllodes tumors, but none has been proven to be clinically useful. We welcome suggestions or questions about using the website. J Breast J (2021) 27:3803. Microscopic (optional): Sections show a stromal proliferation in a leaf-like pattern capped by benign ductal epithelium and intact intervening myoepithelial cell layer. Genetic risk factors of phyllodes tumors are largely unknown, but the literature describes phyllodes tumors in Li-Fraumeni syndrome patients and a mother and daughter pair. The patient, with no family history of breast cancer, had a history of fibroadenoma excision of the left breast 27 years ago. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc. 1992 Mar; [PubMed PMID: 1315437], Adesoye T,Neuman HB,Wilke LG,Schumacher JR,Steiman J,Greenberg CC, Current Trends in the Management of Phyllodes Tumors of the Breast. He underwent a lumpectomy. The imaging features of phyllodes tumor and PDST overlap. 10.1097/00000478-200303000-00007. WebThe Korean Journal of Pathology 2014; 48: 442-444 Periductal Stromal Tumor of Breast 443 CD117. Periductal stromal sarcoma. Provided by the Springer Nature SharedIt content-sharing initiative. WebPeriductal Stromal Tumor of the Breast: One Institution's Review of 6 Tumors Over a 22 Year Period With Immunohistochemical Analysis Int J Surg Pathol. info@meds.or.ke When the size of a fibroadenoma is greater than 5cm with increased stromal cellularity and epithelial hyperplasia on tissue analysis, it is classified as juvenile fibroadenoma (11). A 48-year-old woman was admitted with an 8-year history of right breast mass. Finding stromal fronds on histology allows the correct diagnosis. The epithelial component corresponded to ducts with borders, sometimes double and sometimes with mild to moderate hyperplasia without atypia. The imaging features include the following: 1. multiple solid lobulated lesions comprising nearly the entire right breast; 2. hypoechoic heterogeneous masses with internal separations and abundant blood flow; 3. Am J Surg (2003) 186:35961. In this case, infiltrative growth, rich in interstitial cells, obvious atypia, active mitosis (>10/10 HPF or 5/mm2), and pathological mitosis indicated malignancy. Department of Radiotherapy, National Institute of Oncology, Allal fassi Street, Rabat, 10100, Morocco, Ouafae Masbah,Issam Lalya,Iman Bekkouch,Khalid Hassouni,Tayeb Kebdani,Noureddine Benjaafar&Brahim Khalil Elgueddari, Department of Medical Oncology, National Institute of Oncology, Allal fassi Street, Rabat, 10100, Morocco, Laboratory of Pathology, National Institute of Oncology, Allal fassi Street, Rabat, 10100, Morocco, Laboratory of Pathology, Agdal Oukaimden Street, Rabat, 10100, Morocco, You can also search for this author in PubMed Central 2012 Oct; [PubMed PMID: 22981939], Nielsen VT,Andreasen C, Phyllodes tumour of the male breast. OM and IL analyzed and interpreted the patient data regarding the breast disease, performed the literature research, and wrote the manuscript. Microscopic (optional): Sections show a stromal proliferation featuring areas of leaf-like pattern and stromal expansion with moderate cellularity and stromal atypia. Tel : +33603369775 10.4103/0377-4929.41673. In this care report, we describe the first such case in a child reported in the literature. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Comment rserver un voyage un voyage avec Excursions au Vietnam ? Stromal mitotic figures are frequent. 2012 Jan; [PubMed PMID: 21353414], Liberman L,Bonaccio E,Hamele-Bena D,Abramson AF,Cohen MA,Dershaw DD, Benign and malignant phyllodes tumors: mammographic and sonographic findings. doi:10.3892/ol.2014.2294, 4. Stromal overgrowth is often absent. It is most likely to originate from the periductal stroma ( 10 ). Nous allons vous faire changer davis ! 2021 Oct 15;11:577227. doi: 10.3389/fonc.2021.577227. [2] Rare cases of phyllodes tumors in men are often associated with gynecomastia, suggesting a role for hormonal imbalance. Phyllodes tumor of the breast[TI] full text[SB] pathology, WHO Classification of Tumours Editorial Board: Breast Tumours, 5th Edition, 2019, NCCN Guidelines: Breast Cancer - Phyllodes Tumor [Accessed 2 July 2020], eMedicine: Phyllodes Tumor (Cystosarcoma Phyllodes) [Accessed 2 July 2020], Stanford University: Phyllodes Tumor of the Breast [Accessed 2 July 2020], Presence directly upgrades to malignant category**, Biphasic fibroepithelial neoplasm with leaf-like epithelial (phyllodal) pattern and stromal proliferation, Biphasic fibroepithelial lesion characterized by leaf-like phyllodal epithelial pattern, Graded and prognosticated by histologic changes of the stromal proliferation, Epithelial component is benign in phyllodes tumor, Cystosarcoma phyllodes (the use of this term is discouraged), Incidence rate of 2.1 per 1 million women (, Benign phyllodes tumor most common (60 - 75%), followed by borderline (15 - 26%) and malignant (8 - 20%) tumors (, Benign phyllodes tumor occurs at a younger age compared with borderline and malignant phyllodes tumors (, Can occur rarely in pediatric age group and male, Reported to develop in ectopic breast tissue, including vulva (, Biphasic lesion with epithelial stromal interaction involved in tumorigenesis (, Loss of epithelial interaction in stromal component believed to lead to malignant progression (, Areas resembling well differentiated liposarcoma in phyllodes tumor lack, Increased incidence reported in Li-Fraumeni syndrome (, Commonly presents with firm, asymptomatic, mobile breast mass, Large tumor (up to 20 cm) can cause skin ulceration and pain (, Bloody nipple discharge uncommon and attributed to infarction and intraductal involvement (, Rare cases of hypoglycemia due to insulin-like growth factor II production (, Largely dependent on histologic diagnosis, Ultrasound and mammography do not accurately differentiate phyllodes tumor from fibroadenoma (, Ultrasound unreliable in grading of phyllodes tumor (, Prognosis correlates with histologic grade, Very low rate of local recurrence regardless of margin status (, Does not metastasize or cause mortality (, Recurrences may be benign but may also progress to borderline or malignant phylldoes tumors (, Behavior intermediate between benign and malignant phyllodes tumors (, Higher risk of local recurrence than benign phyllodes tumor, Sites include lung, pleura, bone, central nervous system, visceral organs and soft tissue, Presence of malignant heterologous elements, necrosis and tumor size correlated with metastasis (, Axillary nodal involvement by metastatic disease uncommon, Positive margin status associated with local recurrence, Tumor size is an independent risk factor for local recurrence (, 30 year old woman with painless breast mass (, 37 year old woman with multiple metastases including adrenal gland (, 44 year old woman with repeated local recurrence (, 47 year old woman with malignant phyllodes tumor showing liposarcomatous differentiation (, 70 year old woman with benign phyllodes tumor and concomitant ductal carcinoma in situ (, Narrow margins may be adequate for benign phyllodes tumor, Exact extent of clearance under debate, currently no consensus as to adequate margin width, while 10 mm is generally considered acceptable (, Efficacy of radiotherapy unclear, may improve local control but not overall survival in borderline and malignant phyllodes tumor (, Infiltrative in malignant and less commonly borderline phyllodes tumor, Whorled, bosselated cut surface in a leaf-like pattern, Skin ulceration, hemorrhage and cystic changes in large lesions (, Ulceration and hemorrhage do not indicate malignant behavior per se, Infarcted or very large benign phyllodes tumor can also show necrosis, Leaf-like (phyllodal) epithelial pattern formed by an exaggerated intracanalicular pattern, Subepithelial condensation with increased stromal cellularity adjacent to epithelium, Some regard tumors with predominant periductal stromal expansion (i.e., periductal stromal tumor) as a distinct subtype of phyllodes tumor, Graded into benign, borderline and malignant histologic grades, Cystic degeneration, hemorrhage, stromal hyalinization and myxoid change reported, Multinucleated stromal giant cells occasionally seen (, Can be found in phyllodes tumor of all histologic grades, Epithelium can be scarce in malignant phyllodes tumor with extensive stromal overgrowth, Incidental involvement by in situ and invasive carcinomas (, Myoepithelial layer is preserved but can be attenuated, Reduced epithelial stromal ratio compared with fibroadenomas, Higher nuclear atypia and cellularity in phyllodes tumor of higher grades, Large wavy and folded epithelial clusters, Occasionally, hyperplastic changes with enlarged and vesicular nuclei and small visible nucleoli may be seen, Increased atypia in dispersed cells in phyllodes tumor of higher grades (, Multinucleated tumor cells and marked stromal anaplasia reported in malignant phyllodes tumor (, Chromosome abnormalities increase with grade (. As a biphasic tumor, PDST shows both benign ductal epithelium and non-phyllodes sarcomatous stroma. Other names for these tumors include phylloides tumor and cystosarcoma phyllodes. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Chen WH, Cheng SP, Tzen CY, Yang TL, Jeng KS, Liu CL, Liu TP. The breast lesion was classified as Breast Imaging-Reporting and Data System (BI-RADS) 3 by FFDM and BI-RADS 4A based on DBT and US. T2-weighted images usually show a lobulated mass with hyperintense fluid in slit-like spaces and sometimes hyperintensity in the surrounding tissues. PSS occurs in pre and post menopausal women with a median of age of 55.3 years [2], and before the present case report it had never been described in a child. The mass had been steady at the size of a jujube until it grew rapidly during the few months before admission. 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