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CD10 Positive Recurrent Undifferentiated Mammary Sarcoma in a Young Female: A Rare Case Report with Brief Review of Literature.

Varma K, Gupta P, Das P, Singh P, Misra V - Rare Tumors (2015)

Bottom Line: Large area of necrosis and hemorrhage was present, too.No breast glands were found.Later on, diagnosis was confirmed on immunohistochemical examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Moti Lal Nehru Medical College , Allahabad, Uttar Pradesh, India.

ABSTRACT
Undifferentiated mammary sarcoma is extremely rare and the diagnosis is made only after exclusion of metaplastic carcinomas and malignant phyllodes tumor. Mammary sarcomas mostly display specified entities like liposarcomas or angiosarcomas. A 18-year-old female presented in 2010 with a right breast lump for which lumpectomy was done and on histopathological examination benign phyllodes tumor was diagnosed. In 2011, there was a recurrence at site of excised margin and on fine needle aspiration (FNA) the diagnosis of benign breast disease was made; a small biopsy was received for which diagnosis of myoepithelial lesion was given. Then, the whole mass was excised, but histopathological examination report could not be followed up. In 2013, she again presented with a mass arising from the previously excised margin; on FNA, it was diagnosed as malignant sarcomatous lesion. Microscopy showed spindle shaped cells in diffuse and fascicular pattern with plump ovoid nuclei; coarse chromatin and eosinophilic cytoplasm were seen. Few round to ovoid cells with eccentric nuclei and showing bi- or multi-nucleation were present. Large area of necrosis and hemorrhage was present, too. No breast glands were found. Later on, diagnosis was confirmed on immunohistochemical examination. The case was considered worth due to the young age of the patient and lack of differentiation of the lesion in any specific type of sarcoma and CD10 positivity.

No MeSH data available.


Related in: MedlinePlus

Panel of representative photomicrographs showing (A) gross nodular, solid tissue piece. Inset: inflamed recurrent mass. B) Benign phylloides showing cleft like spaces. Inset showing benign glandular elements. C) Cytology showing scant cellularity. Inset shows plump spindle cells. D) Spindle to ovoid cells with hyper chromatic nuclei, inconspicuous nucleoli and ill defined pale cytoplasm. E) Cytology from recurrent nodule showing increased cellularity and pleomorphism. Inset showing high mitosis. F) Spindle shaped cells arranged in diffuse and fascicular pattern. Inset showing bi- and multi-nucleation and mitosis.
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fig001: Panel of representative photomicrographs showing (A) gross nodular, solid tissue piece. Inset: inflamed recurrent mass. B) Benign phylloides showing cleft like spaces. Inset showing benign glandular elements. C) Cytology showing scant cellularity. Inset shows plump spindle cells. D) Spindle to ovoid cells with hyper chromatic nuclei, inconspicuous nucleoli and ill defined pale cytoplasm. E) Cytology from recurrent nodule showing increased cellularity and pleomorphism. Inset showing high mitosis. F) Spindle shaped cells arranged in diffuse and fascicular pattern. Inset showing bi- and multi-nucleation and mitosis.

Mentions: A 18-year-old female presented with a right breast lump for which lumpectomy was done in 2010. Two nodular masses with attached skin measuring 10×9×3.5 cm and 10×8×6 cm in size were removed (Figure 1A). Cut surface was lobulated with extensive areas of necrosis and hemorrhage. Histopathological examination (HPE) showed double layered epithelial component arranged in clefts with hypercellular stroma organized in leaf-like structures. The stroma consisted of hyperchromatic pleomorphic cells with prominent nucleoli. Mitosis was less than 4/hpf (high power field), hence a diagnosis of benign phyllodes tumor (PT) was made (Figure 1B). One year later, recurrence occurred at the site of excised margin of the tumor. Fine needle aspiration (FNA) showed scant cellularity with plump spindle cells arranged in clusters and also scattered singly. Mitosis was rare. No epithelial cell clusters were seen. A diagnosis of benign breast tumor was made (Figure 1C). A biopsy was received which showed 0.5×0.5 cm spindle cells in diffuse sheets. Few vacuolated cells were also found. No acini or epithelial lining was seen (Figure 1D). A diagnosis of mesenchymal/myoepithelial lesion was given and excision was advised. Patient was lost to follow up and no histopathological examination could be done.


CD10 Positive Recurrent Undifferentiated Mammary Sarcoma in a Young Female: A Rare Case Report with Brief Review of Literature.

Varma K, Gupta P, Das P, Singh P, Misra V - Rare Tumors (2015)

Panel of representative photomicrographs showing (A) gross nodular, solid tissue piece. Inset: inflamed recurrent mass. B) Benign phylloides showing cleft like spaces. Inset showing benign glandular elements. C) Cytology showing scant cellularity. Inset shows plump spindle cells. D) Spindle to ovoid cells with hyper chromatic nuclei, inconspicuous nucleoli and ill defined pale cytoplasm. E) Cytology from recurrent nodule showing increased cellularity and pleomorphism. Inset showing high mitosis. F) Spindle shaped cells arranged in diffuse and fascicular pattern. Inset showing bi- and multi-nucleation and mitosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508640&req=5

fig001: Panel of representative photomicrographs showing (A) gross nodular, solid tissue piece. Inset: inflamed recurrent mass. B) Benign phylloides showing cleft like spaces. Inset showing benign glandular elements. C) Cytology showing scant cellularity. Inset shows plump spindle cells. D) Spindle to ovoid cells with hyper chromatic nuclei, inconspicuous nucleoli and ill defined pale cytoplasm. E) Cytology from recurrent nodule showing increased cellularity and pleomorphism. Inset showing high mitosis. F) Spindle shaped cells arranged in diffuse and fascicular pattern. Inset showing bi- and multi-nucleation and mitosis.
Mentions: A 18-year-old female presented with a right breast lump for which lumpectomy was done in 2010. Two nodular masses with attached skin measuring 10×9×3.5 cm and 10×8×6 cm in size were removed (Figure 1A). Cut surface was lobulated with extensive areas of necrosis and hemorrhage. Histopathological examination (HPE) showed double layered epithelial component arranged in clefts with hypercellular stroma organized in leaf-like structures. The stroma consisted of hyperchromatic pleomorphic cells with prominent nucleoli. Mitosis was less than 4/hpf (high power field), hence a diagnosis of benign phyllodes tumor (PT) was made (Figure 1B). One year later, recurrence occurred at the site of excised margin of the tumor. Fine needle aspiration (FNA) showed scant cellularity with plump spindle cells arranged in clusters and also scattered singly. Mitosis was rare. No epithelial cell clusters were seen. A diagnosis of benign breast tumor was made (Figure 1C). A biopsy was received which showed 0.5×0.5 cm spindle cells in diffuse sheets. Few vacuolated cells were also found. No acini or epithelial lining was seen (Figure 1D). A diagnosis of mesenchymal/myoepithelial lesion was given and excision was advised. Patient was lost to follow up and no histopathological examination could be done.

Bottom Line: Large area of necrosis and hemorrhage was present, too.No breast glands were found.Later on, diagnosis was confirmed on immunohistochemical examination.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Moti Lal Nehru Medical College , Allahabad, Uttar Pradesh, India.

ABSTRACT
Undifferentiated mammary sarcoma is extremely rare and the diagnosis is made only after exclusion of metaplastic carcinomas and malignant phyllodes tumor. Mammary sarcomas mostly display specified entities like liposarcomas or angiosarcomas. A 18-year-old female presented in 2010 with a right breast lump for which lumpectomy was done and on histopathological examination benign phyllodes tumor was diagnosed. In 2011, there was a recurrence at site of excised margin and on fine needle aspiration (FNA) the diagnosis of benign breast disease was made; a small biopsy was received for which diagnosis of myoepithelial lesion was given. Then, the whole mass was excised, but histopathological examination report could not be followed up. In 2013, she again presented with a mass arising from the previously excised margin; on FNA, it was diagnosed as malignant sarcomatous lesion. Microscopy showed spindle shaped cells in diffuse and fascicular pattern with plump ovoid nuclei; coarse chromatin and eosinophilic cytoplasm were seen. Few round to ovoid cells with eccentric nuclei and showing bi- or multi-nucleation were present. Large area of necrosis and hemorrhage was present, too. No breast glands were found. Later on, diagnosis was confirmed on immunohistochemical examination. The case was considered worth due to the young age of the patient and lack of differentiation of the lesion in any specific type of sarcoma and CD10 positivity.

No MeSH data available.


Related in: MedlinePlus