Epithelioid leiomyoma of the breast with granular cell change: A case report

Roncaroli, Federico; Rossi, Renato; Severi, B.; Martinelli, G.; Eusebi, Vincenzo

doi:10.1016/0046-8177(93)90225-6

Cited by 38 publications

(15 citation statements)

References 15 publications

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“…A CD68 immunoreactivity indicates the presence of lysosomes rather than specific histiocytic lineage (14). The absence of desmin and smooth muscle actin immunoreactivity, and the absence of a fascicular growth pattern in the histological features, effectively exclude the possibility of leiomyoma and leiomyosarcoma (5,6). The absence of the anastomosing vascular pattern characteristic of conventional angiosarcoma, and lack of immunoreactivity for factor VIII exclude the possibility of angiosarcoma (7).…”

Section: Discussionmentioning

confidence: 92%

“…The differential diagnosis of the lesion examined includes many cutaneous neoplasms with granular cell changes, such as leiomyoma, leiomyosarcoma, angiosarcoma, basal cell carcinoma, schwannoma, dermatofibrosarcoma protuberans and dermatofibroma (5)(6)(7)(8)(9)(10)(11)(12)(13). It is particularly important that the neoplasm presented should be differentiated from a granular cell dermatofibroma due to simularities of architecture.…”

Section: Discussionmentioning

confidence: 98%

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Dermatofibroma‐like Atypical Granular Cell Tumour

Hong¹,

Yang²,

Lee³

et al. 2005

Acta Dermato-Venereologica

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Sir, Granular cell tumours (GCTs) are uncommon tumours that occur at a wide range of sites (1) and are characterized by granular, acidophilic cytoplasm that contains abundant lysosomes upon ultrastructural examination (2). Although they vary considerably in cellular and nuclear morphology, tumour cells tend to cluster into aggregates, with some situated between bands of collagen. The nuclei are small, round and centrally located, with no mitoses. GCTs are shown to express S-100 protein upon immunohistochemical examination and to contain numerous pleomorphic secondary lysosomes, including occasional angulate forms upon ultrastructural examination. We describe an atypical GCT with a histological architecture resembling that of a dermatofibroma. CASE REPORTA 48-year-old man presented with a solitary, round, dome-shaped hard nodule, 1.061.0 cm in size, and slightly yellow in colour in the pubic area which had grown over a period of 4 years (Fig. 1). The nodule was slow-growing, fixed and painful when subjected to pressure. Examination of haematoxylin and eosinstained sections revealed that the tumour was situated in the reticular dermis with extension into the papillary dermis and associated with mild hyperplasia of the overlying epidermis with elongation of the rete ridges and hyperpigmentation of the basal layer (Fig. 2 top). The tumour was made up of sheets of cells arranged singly and in nests or lobules separated by thin delicate collagen bundles. At the periphery of the lesion, tumour cells were arranged in a whorled pattern, and appeared to be infiltrating the surrounding tissue. The tumour cells were oval, polygonal to spindle-shaped with distinct cellular borders. The majority of cells had abundant eosinophilic granular cytoplasm and small, bland, eccentrically placed nuclei, and considerable variation in cellular and nuclear size was noted. The tumour cell nuclei showed prominent nucleoli, pleomorphism and nuclear contour irregularities (Fig. 2 bottom); however, no mitosis or necrosis was seen. Immunohistochemical staining revealed that tumour cells showed immunoreactivity for S-100, vimentin, neuron-specific enolase and CD68. No immunopositivity for desmin, smooth muscle actin, CD34, CD57, alpha-1-antitrypsin, MAC387, factor VIII and factor XIIIa was observed. Electron microscopy revealed that the tumour was composed of Fig. 2. (top) Hyperplasia of the overlying epidermis and hyperpigmentation of the basal layer (haematoxylin and eosin, original magnification 640). (bottom) Tumour cells show nuclear pleomorphism and prominent nucleoli (6200).Fig. 1. A dome-shaped, hard nodule in the pubic area. Acta Derm Venereol 85 Letters to the Editor

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Dermatofibroma‐like Atypical Granular Cell Tumour

Hong¹,

Yang²,

Lee³

et al. 2005

Acta Dermato-Venereologica

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“…It is important to realize that the presence of cytoplasmic granularity in itself does not indicate a specific cellular lineage, as this may be seen in many tumors both benign and malignant. [7][8][9][10][11][12][13][14][15][16][17] Many authors postulate that mesenchymal stem cells could give rise to granular cell tumors with the potential to differentiate along different cell lines; however, this still remains as an interesting and intriguing hypothesis rather than a fact, given the paucity of experimental data to support this, 1,18,19 and the fact that such divergent differentiation has been described in epithelial tumors as well. 1,17 Cases of conventional granular cell tumors are usually poorly circumscribed, have dark pyknotic nuclei, and show no or few mitotic figures.…”

Section: Discussionmentioning

confidence: 98%

Primitive Nonneural Granular Cell Tumor (So-called Atypical Polypoid Granular Cell Tumor). Report of 2 Cases With Immunohistochemical and Ultrastructural Correlation

Habeeb¹,

Salama²

2008

The American Journal of Dermatopathology

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Primitive nonneural granular cell tumors (so-called atypical cutaneous granular cell tumors) were first described in 1991, followed by few case reports, and 2 recent larger series. We report here 2 additional cases in 2 women aged 73 and 74, who presented with 0.6- and 0.4-cm skin nodules on the right side of the jaw and the forearm, respectively. Biopsies showed cutaneous granular cell neoplasms with epithelioid morphology. The cells exhibited nuclear pleomorphism and brisk mitotic activity with atypical mitoses. Immunohistochemically, the tumor cells expressed vimentin and PGP 9.5 but lacked S-100 and CD34 expression. Ultrastructurally, both cases showed primitive cells packed with large secondary lysosomes. Primitive nonneural granular cell tumors seem to consist of neoplastic proliferating cells that fail to break down uncharacterized cellular material within the lysosomes. They are, however, different from classic granular cell tumor by lacking neural differentiation. Despite reported worrisome cellular atypia, these rare tumors seem to pursue a favorable outcome.

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“…In patients with a confirmed diagnosis of breast leiomyoma, no cases of local recurrence have been reported to date. [11][12][13][14][15][16][17][18][19][22][23][24][25][26][27] We reviewed the literature in MEDLINE and Lilacs using the English keywords "leiomyoma", "fibroid tumors", "benign tumor", "benign neoplasms", "breast tumor", "breast neoplasms" and "ultrasonography". We found 30 case reports that described patients with leiomyoma in the breast parenchyma ( Table 2).…”

Section: Mmg = Mammogram Us = Ultrasonographymentioning

confidence: 99%

“…In this context, the lesions that comprise the differential diagnosis are angioleiomyoma, fibroadenoma and malignant phyllodes tumor. [24][25][26] Because mature adipose tissue is needed to identify cases of hamartoma, this lesion does not provide difficulties in the differential diagnosis. …”

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confidence: 99%

Leiomyoma of the breast parenchyma: a case report and review of the literature

et al. 2017

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INTRODUCTION: Benign tumors are often seen in breast screening examinations. However, the differential diagnosis is not always simple because of radiological similarity between the different benign lesions. CASE REPORT: We present a rare case report of leiomyoma of the breast parenchyma in a 68-year-old asymptomatic patient. The mammographic and ultrasonographic findings were similar to those observed in benign lesions. CONCLUSION: The histopathological diagnosis requires careful differentiation from lesions that have smooth muscle proliferation, especially leiomyosarcoma. The most commonly performed treatment is resection of the lesion with free margins. Although breast leiomyoma is rare, it should be considered among the differential diagnoses for breast nodules of benign appearance. Resection with safety margins proved to be the only treatment needed.

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Epithelioid leiomyoma of the breast with granular cell change: A case report

Cited by 38 publications

References 15 publications

Dermatofibroma‐like Atypical Granular Cell Tumour

Dermatofibroma‐like Atypical Granular Cell Tumour

Primitive Nonneural Granular Cell Tumor (So-called Atypical Polypoid Granular Cell Tumor). Report of 2 Cases With Immunohistochemical and Ultrastructural Correlation

Leiomyoma of the breast parenchyma: a case report and review of the literature

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