Abstract
Phylloides tumor constitutes less than 1% of all breast tumors and 2 - 3% of fibroepithelial breast tumors. Several histological parameters should be evaluated, including stromal cellularity, atypia, mitoses, stromal overgrowth, infiltrative borders, and presence or absence of necrosis. Here we report a case of a 60 years- old female who presented with left breast lump. Fine needle aspiration cytology was done which suggested epithelial hyperplasia with fibrocystic changes. Biopsy was performed which showed predominance of stromal hypercellularity with proliferation of spindle cells (no atypia, mitosis and stromal overgrowth were noticed). However, a focus showed proliferation of discohesive tumor cells arranged singly and in single file. A diagnosis of benign phylloides tumor with foci of invasive lobular carcinoma was made. The diagnosis was confirmed with IHC which showed intense 80%positivity for estrogen and progesterone receptor and spindle cells showing positivity for bcl-2. In situ lobular carcinoma component was not observed. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10321 Journal of Pathology of Nepal (2014) Vol. 4, 597-599
Highlights
Phylloides tumors are distinctly uncommon lesions in the female breast, constituting less than 1% of all breast tumors and 2 - 3% of fibroepithelial breast tumors.[1]
The diagnosis was confirmed with IHC which showed intense 80%positivity for Estrogen and progesterone receptor and spindle cells showing positivity for bcl-2
Some authors consider that the disease is due to a sudden transformation of the hyperplastic epithelium of the phylloides tumor, and others state that the carcinoma is caused haphazardly in the mammary gland adjunct to the phylloides tumor
Summary
Phylloides tumors are distinctly uncommon lesions in the female breast, constituting less than 1% of all breast tumors and 2 - 3% of fibroepithelial breast tumors.[1]. The literature reported the association of phylloides tumors with malignant epithelial components mainly in the form of ductal or lobular in situ lesions and less often in the invasive form. They are usually situated inside the lesion or near the fibroepithelial neoplasm tissue.[3] Here we report a case of phylloides tumor with coexixtent lobular carcinoma with is extremely rare.[4]. H & E stained sections (fig.1a) showed predominantly stromal hypercellularity with proliferation of spindle cells (no atypia, mitosis and stromal overgrowth were noticed). In situ lobular carcinoma component was not observed She subsequently underwent left radical mastectomy with axillary dissection. Histopathology report was negative for residual tumor in breast and lymph nodes
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