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Presented by Dr. Pedram Argani and prepared by Dr. J. David Peske.
This is an 83 year old male with a breast mass.
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1. Question
Diagnosis:
Correct
Answer: C
Histologic Description: This is a spindle cell lesion associated with ectatic vessels. The nuclei focally appeared to palisade. There is focal atypia and mitotic figures are not difficult to identify. Lesional cells label for CD34 and desmin, and demonstrate diffuse nuclear labeling for estrogen receptor. These findings support the diagnosis of myofibroblastoma. The cytologic atypia and occasional mitotic activity support classification as a myofibroblastoma with atypical features, and suggest the need for complete but conservative excision.
Differential Diagnosis: Schwannomas would demonstrate diffuse immunoreactivity for S100 protein, and not label for desmin or estrogen receptor. Gastrointestinal stromal tumor would also label for CD34, but typically does not label for desmin or estrogen receptor. Solitary fibrous tumors also label for CD34, but not for desmin or estrogen receptor.Incorrect
Answer: C
Histologic Description: This is a spindle cell lesion associated with ectatic vessels. The nuclei focally appeared to palisade. There is focal atypia and mitotic figures are not difficult to identify. Lesional cells label for CD34 and desmin, and demonstrate diffuse nuclear labeling for estrogen receptor. These findings support the diagnosis of myofibroblastoma. The cytologic atypia and occasional mitotic activity support classification as a myofibroblastoma with atypical features, and suggest the need for complete but conservative excision.
Differential Diagnosis: Schwannomas would demonstrate diffuse immunoreactivity for S100 protein, and not label for desmin or estrogen receptor. Gastrointestinal stromal tumor would also label for CD34, but typically does not label for desmin or estrogen receptor. Solitary fibrous tumors also label for CD34, but not for desmin or estrogen receptor.
