1/9. leiomyosarcoma of the female breast.Leiomyosarcomas of the breast are rare tumors. Less than 15 such cases have been reported in the literature so far. In this paper authors describe a case of leiomyosarcoma of a female breast presenting as a firm lobulated mass, mimicking a phylloid tumor radiographically. By fine needle aspiration biopsy, on the smears discohesive malignant looking cells were conclusive to a poorly differentiated invasive ductal carcinoma of the breast. The mastectomy specimen contained a lobulated mass, microscopically showing a partly epithelioid spindle cell tumor, immunoreactive for vimentin, desmin, smooth muscle actin antibodies, and negative for epithelial markers, hormone and growth factor receptors. Axillary lymph nodes were free of tumor. A primary leiomyosarcoma of the breast was diagnosed.- - - - - - - - - - ranking = 1keywords = spindle (Clic here for more details about this article) |
2/9. Aspiration cytology of sarcomatoid carcinoma of the breast: Report of a case with cystic change.Sarcomatoid/metaplastic carcinomas of the breast are rare breast malignancies that show a myriad of cytohistologic patterns in aspirates. These poorly differentiated invasive carcinomas contain both ductal and mesenchymal elements with transitional forms displaying either spindle, squamous, chondroid, or osseous differentiation. We describe such a neoplasm in a 68-yr-old woman, the diagnosis of which was missed at the initial fine-needle aspiration (FNA) due to cystic change. Extensive cystic change in a sarcomatoid carcinoma is unusual and is reported for the first time in the English literature.- - - - - - - - - - ranking = 1keywords = spindle (Clic here for more details about this article) |
3/9. Two cases of breast cancer with cartilaginous and osseous metaplasia.Invasive breast cancer (IBC) with cartilaginous or osseous metaplasia is rare. Here we report two cases of this unusual variation. Case 1: The patient was a 33-year-old woman with a right breast tumor, 2.2 cm in size. Mammograms (MMG) presented no specific findings, but ultrasound (US) showed a cystic-like lesion. Excisional biopsy confirmed IBC with cartilaginous and osseous metaplasia. biopsy was followed with a modified radical mastectomy. One lymph node was positive, and both estrogen receptor (ER) and progesterone receptor (PgR) were negative. Case 2: The patient was a 43-year-old woman with a left breast tumor, 4.2 cm in size. MMGs presented no findings but US showed an irregular shaped, low-echoic area, suggesting malignancy. Core needle biopsy confirmed IBC with cartilaginous metaplasia. A total adenectomy and lymph node dissection with breast reconstruction using a lattisimus dorsi muscle flap were performed. Two of 18 lymph nodes were positive for metastasis and both ER and PgR were negative. IBC with cartilaginous or osseus metaplasia seem to be divided into two types pathologically, with or without intervening spindle cells, which is related to the prognosis. Matrix producing carcinoma (MPC) has no intervening spindle cells and a better prognosis than other types, however, MPC has been reported to have the same prognosis as ordinary breast cancer after for adjusting its stage. Our two cases were MPC's and no recurrence has been detected 5 and 3 years from the initial therapy, respectively.- - - - - - - - - - ranking = 7.9202522222108keywords = spindle cell, spindle (Clic here for more details about this article) |
4/9. Metaplastic breast carcinoma histologically mimicking cutaneous spindle cell squamous cell carcinoma.Squamous cell carcinoma is one of the most common primary cutaneous carcinomas but on rare occasion, metastatic squamous cell carcinoma from a distant site or solid organ can present as a cutaneous lesion. Most metastases occur as dermal nodules or involve the dermal lymphatics, but when they are intimately associated with the epidermis, distinguishing the lesion as primary or metastatic may be extremely difficult and usually requires a clinical history or high index of suspicion. A 71-year-old woman presented with multiple eruptive nodules over her chest, flank, and back. Histologically the lesions appeared to be arising from the surface epithelium and consisted of atypical, predominantly spindle cells, some of which streamed off of the epidermis. Following the initial evaluation, a history of breast carcinoma with subsequent radiation therapy and ultimate mastectomy was obtained, and the original breast biopsy and mastectomy material was reviewed. After performing additional studies, it became clear that the origin of the carcinomas was metastatic from an underlying metaplastic breast carcinoma.- - - - - - - - - - ranking = 19.800630555527keywords = spindle cell, spindle (Clic here for more details about this article) |
5/9. Fine needle aspiration cytology of renal and retroperitoneal angiomyolipoma. Report of two cases with cytologic findings and clinicopathologic pitfalls in diagnosis.BACKGROUND: angiomyolipoma is a benign soft tissue neoplasm that usually arises in the kidney, although rare extrarenal examples have been documented. CASES: Two cases of the neoplasm occurred in which fine needle aspiration (FNA) biopsies were performed. The first patient was a 73-year-old female with a history of breast carcinoma who presented with a large retroperitoneal mass. Transabdominal FNA biopsy revealed multiple fragments of spindle-shaped mesenchymal cells, a few of which showed marked cellular atypia with occasional cells containing fat vacuoles, producing a lipoblastlike appearance. However, the atypical spindle cells were immunohistochemically reactive for actin, raising the possibility of a smooth muscle tumor rather than a liposarcoma. The surgically resected specimen revealed an extrarenal, retroperitoneal angiomyolipoma. The second patient was a 71-year-old female who presented with a right renal mass and hepatomegaly. Computed tomography showed a mass in the upper pole of the kidney and multiple enhancing lesions in the liver. FNA biopsy was diagnostic of angiomyolipoma, which was confirmed histologically. CONCLUSION: angiomyolipoma should be considered in aspirates of both renal and extrarenal masses when an admixture of blood vessels, fat and smooth muscle cells is encountered. Pitfalls leading to an incorrect diagnosis include aspiration at unusual sites for angiomyolipoma and/or the presence of atypical spindle cells and lipoblastlike cells, which can be mistaken for leiomyosarcoma or liposarcoma cells. Ancillary studies, such as immunocytochemistry for smooth muscle markers, may be helpful in making the correct diagnosis.- - - - - - - - - - ranking = 8.9202522222108keywords = spindle cell, spindle (Clic here for more details about this article) |
6/9. Metastatic breast carcinoma with appearance resembling micropapillary ductal carcinoma in situ.AIM--To investigate tumour in an axillary lymph node resembling micropapillary ductal carcinoma in situ. methods--Sections of tumour in the breast and axillary lymph node were stained with haematoxylin and eosin, and immunohistochemically with antibodies to basement membrane and myoepithelial cells. RESULTS--Tumour in both the breast and axillary lymph node contained areas resembling micropapillary ductal carcinoma in situ. Surrounding these islands, there was a band of eosinophilic material resembling basement membrane and spindle cells that in places appeared to lie outside the basement membrane. Micropapillary tumour at both sites showed weak and discontinuous staining for collagen IV and laminin. The spindle cells stained for alpha-smooth muscle actin, but not for S100. By contrast, immunohistochemistry showed complete rings of basement membrane and myoepithelial cells around definite ductal carcinoma in situ and normal breast lobules and ducts. CONCLUSIONS--Invasive primary and metastatic carcinoma of the breast can have a growth pattern resembling micropapillary ductal carcinoma in situ.- - - - - - - - - - ranking = 7.9202522222108keywords = spindle cell, spindle (Clic here for more details about this article) |
7/9. Schwannoma with metastatic carcinoma of the breast: an unconventional form of glandular peripheral sheath tumor.We report a schwannoma of the left arm harboring metastatic adenocarcinoma in a 68-year-old woman who had a history of invasive ductal carcinoma of the left breast with widespread metastases. The soft tissue tumor of the left arm had the morphological features of a typical schwannoma except for the presence of multiple foci of moderately to poorly differentiated adenocarcinoma and a grossly visible cyst that was lined by benign appearing cuboidal to low columnar epithelium. The immunohistochemical studies showed that the spindle cells were diffusely and strongly positive for vimentin, S-100 protein, and collagen type iv, and focally reactive for Leu 7. The cyst and the foci of adenocarcinoma were both stained for cytokeratin, but the adenocarcinomatous foci also were immunoreactive for estrogen receptor, gross cystic disease fluid protein, and focally for S-100 protein, in contrast to the lack of positivity for these three markers in the epithelium of the cyst. To the best of our knowledge this case is a unique one of a schwannoma with metastatic mammary carcinoma producing yet another variation on the theme of a glandular peripheral nerve sheath tumor.- - - - - - - - - - ranking = 3.9601261111054keywords = spindle cell, spindle (Clic here for more details about this article) |
8/9. Aspiration cytology of malignant intraductal myoepithelioma of the breast. A case report.The cytologic features of a fine needle aspiration biopsy of a malignant intraductal myoepithelioma of the breast are described. On cytology the tumor cells were shed in cohesive groups consisting of ill-defined polygonal and spindle cells. The latter, which had centrally located, cigar-shaped nuclei, showed a fascicular pattern. Despite cellular multilayering, there was a halo-like transparency around the nuclei, suggesting that many cells had clear or pale cytoplasm. Mild nuclear atypia was occasionally present. Mitotic figures were also observed. With immunostaining, clustered cells showed a diffuse positive reaction for alpha smooth muscle actin (alpha-SM-actin). The tumor cells proliferated intraductally, as in a conventional intraductal carcinoma with a comedo or solid pattern. Characteristically, zones of clear, polygonal cells were situated at the ductal periphery. Toward the center of each duct, tumor cells were transformed into nonclear cells, and some were further transformed into spindle cells that tended to form fascicles. Immunohistochemically, most of the tumor cells expressed alpha-SM-actin.- - - - - - - - - - ranking = 7.9202522222108keywords = spindle cell, spindle (Clic here for more details about this article) |
9/9. cytogenetic analysis shows that carcinosarcomas of the breast are of monoclonal origin.carcinosarcoma of the breast is a rare biphasic neoplasm composed of a carcinomatous component contiguous or admixed with a pleomorphic spindle cell component. The issues of the histogenesis and clonal composition of carcinosarcomas have long been debated. We present the first cytogenetic characterization of mammary carcinosarcomas by analysis of eight tumor samples from two patients with this disease. In the first case, the same karyotypically complex clone, as well as evidence of clonal evolution, was found in samples from three separate areas of the primary tumor. The analysis of one intramammary and one axillary lymph node metastasis from the same patient, both showing only the sarcomatous tumor component, also revealed the common complex stemline and one of the two sidelines found in the primary tumor. The carcinosarcoma of the second patient contained six complex but karyotypically related clones unevenly distributed among the three samples examined. From this case, cells belonging to the carcinomatous and sarcomatous tumor components were separated by differential sedimentation and culturing in specific growth media. Analysis of both fractions showed largely the same karyotype, although one of the subclones was restricted to the epithelial component. Our findings indicate that the epithelial and mesenchymal components of mammary carcinosarcomas are both part of the neoplastic parenchyma and that they have evolved from a single common stem cell, in agreement with the hypothesis that the tumors are of monoclonal origin.- - - - - - - - - - ranking = 3.9601261111054keywords = spindle cell, spindle (Clic here for more details about this article) |