Department of Pathology, Yonsei University Wonju College of Medicine, Wonju, South Korea.
Pathol Int. 2012 Feb;62(2):120-6. doi: 10.1111/j.1440-1827.2011.02761.x. Epub 2011 Dec 6.
We analyzed histopathological features of core needle biopsy (CNB) and surgical excision specimen comparatively in 129 patients with surgically proven phyllodes tumor (PT). Stromal characteristics including cellularity, atypia, mitosis, overgrowth, tissue fragmentation, and the tumor margin were assessed. Benign/borderline/malignant phyllodes tumor (PT) were diagnosed in 90 (69.8%)/30 (23.3%)/9 (7.0%) patients. Among the 90 cases of benign PTs, 67 cases (74.4%) were diagnosed concordantly in CNB. For borderline and malignant PTs, three out of eight (26.6%) and four out of nine (44.4%) cases were diagnosed concordantly in CNBs. All 50 cases of discordant diagnosis were underestimated in matched CNBs, especially in their stromal cellularity and mitosis. The size of tumor is larger in discordant cases of PT (P= 0.013). The concordant rate of diagnosis between CNB and surgical excision was about 60% and accordingly, grading of PT based on the histological findings in CNBs has limitation. The discordance comes from heterogeneous stromal properties of PTs.
我们对 129 例经手术证实的叶状肿瘤（PT）患者的核心针活检（CNB）和手术切除标本进行了组织病理学特征比较分析。评估了间质特征，包括细胞密度、异型性、有丝分裂、过度生长、组织碎片和肿瘤边缘。诊断为良性/交界性/恶性叶状肿瘤（PT）的患者分别为 90 例（69.8%）、30 例（23.3%）和 9 例（7.0%）。在 90 例良性 PT 中，67 例（74.4%）在 CNB 中诊断一致。对于交界性和恶性 PT，8 例中有 3 例（26.6%）和 9 例中有 4 例（44.4%）在 CNB 中诊断一致。所有 50 例不一致诊断的病例在匹配的 CNB 中均被低估，尤其是在间质细胞密度和有丝分裂方面。PT 不一致病例的肿瘤大小更大（P=0.013）。CNB 和手术切除的诊断一致性约为 60%，因此，基于 CNB 中组织学发现对 PT 进行分级存在局限性。不一致来自于 PT 的间质性质不均一。
