| Jia Li. A pulmonary metastatic breast phyllodes tumor and clinicopathology analysis. Oncol Transl Med, 2018, 4: 31-34. |
| A pulmonary metastatic breast phyllodes tumor and clinicopathology analysis |
| Received:February 05, 2018 Revised:March 28, 2018 |
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| KeyWord:breast phyllodes tumor; pulmonary metastasis |
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| Abstract: |
| Objective Breast phyllodes tumors (PTs) are rare fibroepithelial tumors that are characterized by
formation of foliation patterns. Behaviorally, only relatively poor prediction of PTs is possible based on their
histological appearance. PTs are frequently misdiagnosed because they are difficult to differentiate from
soft tissue tumors. In this report, we describe the pathological features of a rare case of PT and review the
relevant literature, summarizing the essentials of the diagnosis and differential diagnosis, while attempting
to avoid misdiagnosis or missed diagnosis of the tumor to the best of our abilities.
Methods We present a case of pulmonary metastatic lobular tumor, analyzing the morphological
[hematoxylin-eosin (HE) staining] and immunohistochemical (streptavidin perosidase method, SP) features
of the tissue.
Results Long spindle-shaped tumor cells were observed using microscopy. The cells were arranged in
bundles, with a whirlpool pattern, and braided. The proliferation of the spindle cells was markedly atypical
and karyokinesis was elevated. Residual ductal epithelium was detected in some areas, and the margins
of the tumor tissues showed invasive growth. Immunohistochemical studies of the spindle-shaped tumor
cells were positive for actin, PR, CD10, SMA, Bcl-2, and negative for CKP, S-100, CD34, ER. The Ki-67
index was 40%.
Conclusion The spindle cell tumor identified in the lung should first be considered as a metastatic
neosplasm, because most soft-tissue sarcomas commonly metastasize through the bloodstream to the
lungs. Although malignant breast PTs are rare, a detailed medical history that includes prior surgical history
is required to avoid wrongful or missed diagnosis. |
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