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Pleomorphic adenoma of breast: a radiological and pathological study of a common tumor in an uncommon location.

Ginter PS, Scognamiglio T, Tauchi-Nishi P, Antonio LB, Hoda SA - Case Rep Pathol (2015)

Bottom Line: Pleomorphic adenoma occurs commonly in the major salivary glands but is uncommonly encountered in the breast.Herein, we report a case of pleomorphic adenoma of the breast which was preoperatively thought to represent a fibroadenoma on clinical and radiological grounds.It is the rarity of the tumor in the breast, rather than its histological appearance, that causes diagnostic difficulty.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USA.

ABSTRACT
Pleomorphic adenoma occurs commonly in the major salivary glands but is uncommonly encountered in the breast. In both of these locations, the tumor is typically grossly circumscribed and has a "mixed" histological appearance, being composed of myoepithelial and epithelial components amid a myxochondroid matrix. Herein, we report a case of pleomorphic adenoma of the breast which was preoperatively thought to represent a fibroadenoma on clinical and radiological grounds. It is the rarity of the tumor in the breast, rather than its histological appearance, that causes diagnostic difficulty.

No MeSH data available.


Related in: MedlinePlus

Pleomorphic adenoma of the breast. (a) Ultrasound showing a well-circumscribed, hypoechoic mass. (b) Cut sectioning showed a firm, well-circumscribed mass with whitish, homogeneous surface (bar: 1.0 cm). ((c) and (d)) Histological section shows the tumor to be composed of stromal and epithelial elements. The stromal component is comprised of bland spindle cells embedded in a myxochondroid matrix. (e) The epithelial component shows scattered compressed glands interspersed in the stroma. (f) Calponin immunostain highlights stromal and periglandular myoepithelial cells. The epithelial cells are negative for calponin.
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fig1: Pleomorphic adenoma of the breast. (a) Ultrasound showing a well-circumscribed, hypoechoic mass. (b) Cut sectioning showed a firm, well-circumscribed mass with whitish, homogeneous surface (bar: 1.0 cm). ((c) and (d)) Histological section shows the tumor to be composed of stromal and epithelial elements. The stromal component is comprised of bland spindle cells embedded in a myxochondroid matrix. (e) The epithelial component shows scattered compressed glands interspersed in the stroma. (f) Calponin immunostain highlights stromal and periglandular myoepithelial cells. The epithelial cells are negative for calponin.

Mentions: A 42-year-old woman presented with a slowly growing palpable mass in the left breast. An ultrasound showed a well-circumscribed, hypoechoic mass that spanned 1.4 cm and was located at 1:00, 2 cm from the nipple (Figure 1(a)). The preoperative clinical and radiological impression was that of a fibroadenoma. A firm, well-circumscribed, 1.2 cm, mass was excised. Serial sectioning revealed whitish, homogeneous, cut surfaces (Figure 1(b), bar: 1.0 cm). Microscopically, the tumor was comprised of an admixture of stromal and epithelial elements. The dominant stromal component was characterized by bland spindled myoepithelial cells embedded in a largely myxoid, focally chondroid, matrix (Figures 1(c) and 1(d)). The epithelial component, represented by scattered compressed glands interspersed in the stroma, was cytologically insipid and mitotically quiescent (Figure 1(e)). The native breast glandular parenchyma, minimally represented in the specimen at the perimeter of the tumor, was inactive. There was no evidence of associated papilloma or adenomyoepithelioma. The lesional stromal myoepithelial cells and the periglandular myoepithelial cells were immunoreactive for calponin (Figure 1(f)), high molecular weight cytokeratin (CK-K903), and p63. The gross, histological and immunohistochemical findings in this tumor were characteristic of mammary PA. The most recent follow-up ultrasound examination of the ipsilateral breast, performed 5 months following the excisional biopsy, showed no evidence of residual or recurrent disease.


Pleomorphic adenoma of breast: a radiological and pathological study of a common tumor in an uncommon location.

Ginter PS, Scognamiglio T, Tauchi-Nishi P, Antonio LB, Hoda SA - Case Rep Pathol (2015)

Pleomorphic adenoma of the breast. (a) Ultrasound showing a well-circumscribed, hypoechoic mass. (b) Cut sectioning showed a firm, well-circumscribed mass with whitish, homogeneous surface (bar: 1.0 cm). ((c) and (d)) Histological section shows the tumor to be composed of stromal and epithelial elements. The stromal component is comprised of bland spindle cells embedded in a myxochondroid matrix. (e) The epithelial component shows scattered compressed glands interspersed in the stroma. (f) Calponin immunostain highlights stromal and periglandular myoepithelial cells. The epithelial cells are negative for calponin.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4373341&req=5

fig1: Pleomorphic adenoma of the breast. (a) Ultrasound showing a well-circumscribed, hypoechoic mass. (b) Cut sectioning showed a firm, well-circumscribed mass with whitish, homogeneous surface (bar: 1.0 cm). ((c) and (d)) Histological section shows the tumor to be composed of stromal and epithelial elements. The stromal component is comprised of bland spindle cells embedded in a myxochondroid matrix. (e) The epithelial component shows scattered compressed glands interspersed in the stroma. (f) Calponin immunostain highlights stromal and periglandular myoepithelial cells. The epithelial cells are negative for calponin.
Mentions: A 42-year-old woman presented with a slowly growing palpable mass in the left breast. An ultrasound showed a well-circumscribed, hypoechoic mass that spanned 1.4 cm and was located at 1:00, 2 cm from the nipple (Figure 1(a)). The preoperative clinical and radiological impression was that of a fibroadenoma. A firm, well-circumscribed, 1.2 cm, mass was excised. Serial sectioning revealed whitish, homogeneous, cut surfaces (Figure 1(b), bar: 1.0 cm). Microscopically, the tumor was comprised of an admixture of stromal and epithelial elements. The dominant stromal component was characterized by bland spindled myoepithelial cells embedded in a largely myxoid, focally chondroid, matrix (Figures 1(c) and 1(d)). The epithelial component, represented by scattered compressed glands interspersed in the stroma, was cytologically insipid and mitotically quiescent (Figure 1(e)). The native breast glandular parenchyma, minimally represented in the specimen at the perimeter of the tumor, was inactive. There was no evidence of associated papilloma or adenomyoepithelioma. The lesional stromal myoepithelial cells and the periglandular myoepithelial cells were immunoreactive for calponin (Figure 1(f)), high molecular weight cytokeratin (CK-K903), and p63. The gross, histological and immunohistochemical findings in this tumor were characteristic of mammary PA. The most recent follow-up ultrasound examination of the ipsilateral breast, performed 5 months following the excisional biopsy, showed no evidence of residual or recurrent disease.

Bottom Line: Pleomorphic adenoma occurs commonly in the major salivary glands but is uncommonly encountered in the breast.Herein, we report a case of pleomorphic adenoma of the breast which was preoperatively thought to represent a fibroadenoma on clinical and radiological grounds.It is the rarity of the tumor in the breast, rather than its histological appearance, that causes diagnostic difficulty.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USA.

ABSTRACT
Pleomorphic adenoma occurs commonly in the major salivary glands but is uncommonly encountered in the breast. In both of these locations, the tumor is typically grossly circumscribed and has a "mixed" histological appearance, being composed of myoepithelial and epithelial components amid a myxochondroid matrix. Herein, we report a case of pleomorphic adenoma of the breast which was preoperatively thought to represent a fibroadenoma on clinical and radiological grounds. It is the rarity of the tumor in the breast, rather than its histological appearance, that causes diagnostic difficulty.

No MeSH data available.


Related in: MedlinePlus