Breast tumors with myofibroblastic differentiation: clinico-pathological observations in myofibroblastoma and myofibrosarcoma

Gocht, Andreas; Bösmüller, H.; Bässler, R; Tavassoli, F. A.; Moinfar, Farid; Katenkamp, D.; Schirrmacher, K.; Lüders, Petra; Saeger, Wolfgang

doi:10.1016/s0344-0338(99)80087-9

Cited by 62 publications

(47 citation statements)

References 27 publications

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“…Most tumors (9 of 13) were classified as MFBs on the basis of their proven myofibroblastic differentiation by means of immunocytochemistry (significant expression of α-smooth muscle actin and desmin) as previously reported [22,26,30,35,41,43,54,63]. They also exhibited a variable expression of ER, PR, and AR (Table 1).…”

Section: Tumor Classificationmentioning

confidence: 88%

See 1 more Smart Citation

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

181

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: Tumor Classificationmentioning

confidence: 88%

“…vi. SCL-like tumor, SFT, and MFB display a basic common immunophenotype, with neoplastic cells immunoreactive to vimentin, CD34, BCL-2, and CD99 [13,22,24,25,40,43], although with a variable degree of expression, especially in MFB. vii.…”

Section: Discussionmentioning

confidence: 99%

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

181

165

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“…They occur at any age (range 9-75 years, mean 40 years) with a slight male predominance and with tumour size ranging from 1.5 cm to 17 cm. Tumours can arise in extremities and trunk (including breast or retroperitoneum), but there is a predilection (up to one-third of cases) for the head and neck region in both soft tissue (including oral cavity and especially tongue, face and neck) and bone (notably maxilla and mandible) [2,3,18,19,30,31,42,55,58,62,70,74,77].…”

Section: Low-grade Myofibrosarcomamentioning

confidence: 99%

Myofibrosarcoma

Fisher

2004

Virchows Arch

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Myofibrosarcomas are malignant tumours of myofibroblasts, which have been recognised for many years, but have become clearly defined only recently. They are low- or high-grade sarcomas that arise in soft tissue or bone in adults or children. Low-grade myofibrosarcomas are infiltrative tumours, usually in deep soft tissue, with a predilection for the head and neck region, which display a range of microscopic appearances from fasciitis-like to fibrosarcoma-like; all cases at least focally display nuclear pleomorphism. They express smooth-muscle actin and calponin, and some express desmin, but most lack h-caldesmon. Low-grade myofibrosarcomas can recur but rarely metastasise. Their differential diagnosis is from benign myofibroblastic proliferations, such as fasciitis and fibromatosis, as well as from fibrosarcoma and leiomyosarcoma. Pleomorphic myofibrosarcomas are high-grade pleomorphic sarcomas (malignant fibrous histiocytoma), which show ultrastructural evidence of myofibroblastic differentiation. They closely resemble malignant fibrous histiocytoma clinically and morphologically, but are more frequently actin positive. This article describes the low- and high-grade variants of myofibrosarcoma and other malignant tumours with myofibroblastic differentiation.

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“…Myofibroblasts were observed in well-differentiated fibrosarcoma in 1975 [109], and the first ''sarcoma of myofibroblasts'' was reported 3 years later [110]. About 50 cases have since appeared in the literature [104,[111][112][113][114][115][116][117][118][119][120][121][122].…”

Section: Low-grade Myofibrosarcomamentioning

confidence: 99%

Low-grade Sarcomas with CD34-Positive Fibroblasts and Low-Grade Myofibroblastic Sarcomas

Fisher

2004

Ultrastructural Pathology

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Breast tumors with myofibroblastic differentiation: clinico-pathological observations in myofibroblastoma and myofibrosarcoma

Cited by 62 publications

References 27 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

Myofibrosarcoma

Low-grade Sarcomas with CD34-Positive Fibroblasts and Low-Grade Myofibroblastic Sarcomas

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