Pătraşcu Anca, Popescu Carmen Florina, Pleşea I E, Bădulescu Adriana, Tănase Florentina, Mateescu Garofiţa
Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Romania.
Rom J Morphol Embryol. 2009;50(4):605-11.
The frequency of mesenchymal breast tumors is very low, being represented mostly by tumors with biphasic proliferation (phyllodes tumors) and less by other types of non-epithelial tumors. From clinical point of view, phyllodes tumors (PT) can mimic a breast carcinoma. Therefore, the preoperative diagnosis by cytological examination on material obtained by fine needle aspiration (FNA) is very important for adequate treatment of these tumors. In current study, we assessed clinical aspects of 79 phyllodes tumors regarding patient's age and localization of the tumors. In 17 out of 79 cases, it has been performed FNA within the tumors with further cytological examination on the smears obtained. The median age of the patients was 46.07-year-old, being progressively higher with grade of the tumors with significant values between benign and borderline tumors (p=0.04954) and between benign and malignant ones (p=0.02890). The distinguish on the smears of stromal fragments and naked stromal nuclei with variable grade of atypia regarding the tumoral type, in detriment of epithelial elements have been conclusive for fibroepithelial lesion as cytopathological diagnosis. The preoperative differentiation between a breast phyllodes tumor and a breast carcinoma is extremely important for avoiding of a useless radical surgery for the patient. If the fine needle aspiration was correctly performed, the accuracy of the cytodiagnosis has been 82% in current study.
间质性乳腺肿瘤的发生率非常低,主要表现为具有双相增殖的肿瘤(叶状肿瘤),其他类型的非上皮性肿瘤则较少见。从临床角度来看,叶状肿瘤(PT)可能会模仿乳腺癌。因此,通过细针穿刺抽吸(FNA)获取的材料进行细胞学检查的术前诊断对于这些肿瘤的适当治疗非常重要。在本研究中,我们评估了79例叶状肿瘤患者的年龄和肿瘤定位等临床情况。在79例病例中的17例中,对肿瘤内部进行了FNA,并对获得的涂片进行了进一步的细胞学检查。患者的中位年龄为46.07岁,随着肿瘤分级的增加而逐渐升高,在良性与交界性肿瘤之间(p = 0.04954)以及良性与恶性肿瘤之间(p = 0.02890)具有显著差异。涂片上根据肿瘤类型区分具有不同异型性等级的间质碎片和裸露的间质细胞核,而上皮成分较少,这对于纤维上皮病变的细胞病理学诊断具有决定性意义。乳腺叶状肿瘤与乳腺癌的术前鉴别对于避免对患者进行无用的根治性手术极为重要。在本研究中,如果细针穿刺抽吸操作正确,细胞诊断的准确率为82%。