MEETING No. 33, JULY 18th, 2001, NIGUARDA HOSPITAL, MILAN

Case 1
Case 2
Case 3
Case 4

Case 1

“BREAST NODULE”
A. M. FERRARI - S. Pio X Private Hospital, Milano
(pict. by dr. Clemente)

Clinical history: a 81y.o. woman presents with a left, retro-areolar, breast nodule. A FNA and a needle biopsy are performed and then following the biopsy diagnosis the nodule is removed.
FNA and biopsy microscopic diagnosis: the smears are moderately cellular and show mainly isolated, spindled shaped (pict. 1), bare nuclei,,ly occasionally in small aggregates.
There is slight polymorphism and no mitoses are seen. There are no epithelial ductal cells.
The needle biopsy confirms the cytological diagnosis of mesenchymal neoplasia, consisting of numerous spindled cells, with mild anisokaryosis but no mitoses and with a vaguely storiform pattern (pict. 2).
On this biopsy the diagnosis of phyllode tumor is not excluded and the excision of the tumor is suggested.
Macroscopic description: a quadrantectomy is performed and it shows an apparently well defined, 5.5cm, multi-lobulated, whitish, hard nodule (pict. 3) which is at 2 cm from the overlying skin (pict. 4).
Microscopic description: sections show a spindled cells neoplasia with storiform pattern (pict. 5 - pict. 6 - pict. 7) which infiltrates irregularly the surrounding breast parenchyma; at the periphery of the tumor there are residual breast ducts which confirm that the tumor has no relation with the dermis or the skin but arise directly in the breast tissue.
There are no epithelial structures in the lesion, instead. The neoplastic cells are strongly positive with immunohistochemical staining for CD34 (pict. 8).

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8

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