Epithelioid Myofibroblastoma of the Breast: A Report of Two Cases with Discussion of Diagnostic Pitfalls

Alizadeh, Layla; Alkhasawneh, Ahmad; Reith, John D.; Al-Quran, Samer Z.

doi:10.1111/tbj.12498

Cited by 9 publications

(5 citation statements)

References 9 publications

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“…[ 9 ] reported a case of MFB which was diagnosed as invasive lobular carcinoma on needle biopsy and underwent lumpectomy with unnecessary sentinel node dissection. Similarly, epithelioid and lipomatous variants misinterpreted as metaplastic carcinoma [ 10 ] have been reported in the past. IHC is therefore imperative for confirmation.…”

Section: Discussionmentioning

confidence: 94%

Myofibroblastoma of the Breast: A Rare Cause of Breast Lump in a Postmenopausal Woman

et al. 2018

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A breast mass in a postmenopausal age woman is treated with a high index of clinical suspicion for malignancy. Myofibroblastoma (MFB) of the breast is a very rare benign stromal tumor, predominantly occurring in menopausal women and older men. Owing to its rarity, nonspecific radiology, cytomorphology, and many variants, it can be confused with other malignant and benign breast lesions and hence can be a source of diagnostic pitfall. We present a case of an MFB of the breast in a 55-year-old female, which was detected on a routine screening mammography. Fine-needle aspiration cytology was inconclusive. Final diagnosis was made by histopathology and immunohistochemistry examination. We report this case as the likelihood of encountering MFB has increased in recent years due to routine mammographic screening, and this lesion should be kept in the differential diagnosis of spindle-cell lesions of the breast.

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Section: Discussionmentioning

confidence: 94%

Myofibroblastoma of the Breast: A Rare Cause of Breast Lump in a Postmenopausal Woman

et al. 2018

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“…Among these variants, the epithelioid MFB may represent a diagnostic pitfall, this particular variant can mimic invasive carcinoma. 2,10–14 This variant is composed mostly of epithelioid cells which comprise at least 50% of the tumor 15 Grossly, the epithelioid MFB, ranging in size from 15 to 50 mm at the largest diameter. 4,7 The epithelioid cells are medium-sized, oval to polygonal, with abundant eosinophilic cytoplasm and round to oval, eccentrically placed nuclei containing small evident nucleoli.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Challenges of Intra-operative Frozen Consultation for Mammary Epithelioid Myofibroblastoma

et al. 2022

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Myofibroblastoma (MFB) of the breast is a rare benign neoplasm that exhibits several morphologic variants and presents diagnostic challenges for pathologists, especially in recognizing intra-operative frozen sections. In order to raise awareness of this tumor and avoid misdiagnosis, we describe a case of a 38-year-old female patient diagnosed as epithelioid MFB. This painless tumor was well-circumscribed, found in the left breast and was physically examined over a period of six months. Histologically, this tumor was predominantly composed of epithelioid cells, which arranged as single cells, small clusters or nests. Tumor stroma was collagenized with spindle cells, adipose and focal myxoid areas. This case was misinterpreted as invasive carcinoma in the frozen section. The immunohistochemical profile demonstrated positivity for Vimentin, desmin, SMA, calponin, CD34, ER, PR and AR, whereas pan-keratin, keratin 7, keratin 34βE12, keratin 5/6, EMA, p63 and S100 were negative. RB1 was abnormally negative, confirming the diagnosis of epithelioid MFB. Making a correct diagnosis is primarily dependent on awareness by the pathologist of this unusual variant of MFB and careful integration of clinicopathologic findings to avoid potential diagnostic pitfalls.

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“…The epithelioid variant is important to recognize as it may mimic invasive mammary lobular carcinoma. 52 The lesional spindle cells of myofibroblastoma are positive for CD34 and desmin. They may also stain for SMA, ER, PR, CD99, BCL-2, and CD10.…”

Section: Cytologic Featuresmentioning

confidence: 99%

“…Other variants include cellular, epithelioid, deciduoid, lipomatous, myxoid, and collagenized. The epithelioid variant is important to recognize as it may mimic invasive mammary lobular carcinoma . The lesional spindle cells of myofibroblastoma are positive for CD34 and desmin.…”

Section: Introductionmentioning

confidence: 99%

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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Epithelioid Myofibroblastoma of the Breast: A Report of Two Cases with Discussion of Diagnostic Pitfalls

Cited by 9 publications

References 9 publications

Myofibroblastoma of the Breast: A Rare Cause of Breast Lump in a Postmenopausal Woman

Myofibroblastoma of the Breast: A Rare Cause of Breast Lump in a Postmenopausal Woman

Diagnostic Challenges of Intra-operative Frozen Consultation for Mammary Epithelioid Myofibroblastoma

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

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