Leiomyosarcoma of the breast: A difficult diagnosis on fine‐needle aspiration biopsy

Wei, Xiao Jun; Hiotis, Karen; Garcı́a, Roberto; Ph, Levine

doi:10.1002/dc.10359

Cited by 19 publications

(7 citation statements)

References 44 publications

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“…It is difficult to reach a diagnosis based on fine needle aspiration (FNA) cytology. However, preoperative diagnosis can be achieved using a combination of FNA cytology and immunohistochemistry [3,10]. …”

Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma of the Breast: A Case Report

2012

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Primary leiomyosarcoma of the breast is an extremely rare tumor, accounting for less than 1% of all breast tumors and only 24 cases have been reported in the English medical journals. It is quite difficult to diagnose leiomyosarcoma preoperatively. Establishing an accurate diagnosis is very important in planning treatment. When preoperative diagnosis can be achieved before or during the operation, wide resection should be performed. There is no need for axillary lymph node dissection. In this case report, we present a case involving primary leiomysarcoma of the breast in a 48-year-old woman and we discuss optimal treatment options.

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Section: Discussionmentioning

confidence: 99%

Primary Leiomyosarcoma of the Breast: A Case Report

2012

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“…Leiomyosarcoma of the breast is a very unusual tumor, and its FNA cytologic findings have been reported only in several cases . Their FNA specimens were cellular, composed of both round and spindle‐shaped cells with elongated, oval, or blunt‐ended (cigarette shaped) nuclei.…”

Section: Discussionmentioning

confidence: 99%

Fine needle aspiration cytology of nodular fasciitis of the breast

Sakuma¹,

Matsuo

Koike³

et al. 2014

Diagnostic Cytopathology

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We report a case of nodular fasciitis (NF) of the breast, which was cytologically diagnosed as a spindle cell proliferation with undetermined malignant potential. Owing to small size of the lesion (5.9 × 3.7 × 4.1 mm), only fine needle aspiration (FNA) cytology was performed under ultrasound guidance. The FNA smears were cellular, rich in single/clustered spindle cells but mammary ductal epithelial/myoepithelial cells were absent. These cytologic findings suggested spindle cell growth of mesenchymal origin. Pattern-less arrangement of spindle cells, heterogeneous composition of the stromal matrix, lack of nuclear/cellular atypia, occasional mitosis but no aberrant mitotic figures, and lymphocyte infiltration indicated reactive rather than neoplastic nature of the lesion. Nonetheless, lumpectomy was conducted because the possibility of neoplasm was not completely ruled out. The histologic diagnosis of the resected nodule was NF. FNA specimens were reviewed thoroughly in an attempt to define the key cytomorphologic features of NF that are important for the correct diagnosis. Differential diagnoses from the lesions that show similar cytologic pictures are discussed in detail. Although NF arising from the breast is rare, cytopathologists should be aware of its clinical and cytopathologic characteristics. Knowledge of the possibility of NF in the breast and its cytologic findings may help cytopathologists to discern its reactive, not neoplastic, characteristics of the lesion. If the referring surgeon is alerted NF as a possibility along with other differential diagnoses, close observation would become a management option. In-depth discussion of cytologic features and a review of the pertinent literature are also included.

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“…The cells are spindled to polygonal with moderate to marked pleomorphism, hyperchromasia, prominent nucleoli and sometimes vacuolated cytoplasm. Mitotic figures are frequent …”

Section: Introductionmentioning

confidence: 99%

“…If cytologic material is adequate for ancillary testing, a panel of immunohistochemical stains including CD34, S100, desmin, and smooth muscle actin may be helpful in reaching the correct diagnosis. The differential diagnosis for leiomyosarcomas includes poorly differentiated carcinoma, spindle cell metaplastic carcinoma, malignant phyllodes tumor, and other primary breast sarcomas . If adequately sampled, the finding of biphasic cell populations including both stromal cells and ductal cells favors the diagnosis of phyllodes tumor.…”

Section: Introductionmentioning

confidence: 99%

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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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Leiomyosarcoma of the breast: A difficult diagnosis on fine‐needle aspiration biopsy

Cited by 19 publications

References 44 publications

Primary Leiomyosarcoma of the Breast: A Case Report

Primary Leiomyosarcoma of the Breast: A Case Report

Fine needle aspiration cytology of nodular fasciitis of the breast

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

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