Magro Gaetano
Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Anatomic Pathology Section, School of Medicine, University of Catania, Catania, Italy.
Histol Histopathol. 2016 Jan;31(1):1-23. Epub 2015 Sep 2.
Myofibroblastoma (MFB) is a rare benign mesenchymal tumor which usually occurs in the breast parenchyma of both females and males. Although this tumor is typically composed of bland-looking spindle-shaped cells arranged in short fascicles interrupted by keloidal-like collagen fibers, several variations on this basic morphological theme do exist. With the advent of mammographic screening, an increased number of mammary MFBs are being detected and pathologists should be aware of the wide morphological and immunohistochemical spectrum exhibited by this unusual tumor. This review focuses on the most diagnostically challenging variants of mammary MFB, which could represent potential diagnostic pitfalls of malignancy, especially when evaluating needle core biopsies. In this regard the following variants of MFB, including the most recently recognized, will be presented: myxoid MFB, lipomatous MFB, epithelioid cell MFB, deciduoid cell MFB, epithelioid cell MFB with multinodular growth pattern, palisaded/schwannian-like MFB and MFB with extensive myxo-edematous stromal changes. Histological illustrations along with differential diagnostic problems for each single variant of MFB will be provided to offer helpful suggestions for a correct diagnostic approach in daily practice.
肌成纤维细胞瘤（MFB）是一种罕见的良性间叶组织肿瘤，通常发生于女性和男性的乳腺实质。尽管该肿瘤通常由排列成短束状、外观平淡的梭形细胞组成，这些短束状细胞被类瘢痕样胶原纤维中断，但在这种基本形态学特征基础上确实存在一些变异。随着乳腺钼靶筛查的出现，越来越多的乳腺肌成纤维细胞瘤被检测出来，病理学家应了解这种不寻常肿瘤所呈现的广泛形态学和免疫组化特征。本综述聚焦于乳腺肌成纤维细胞瘤最具诊断挑战性的变异型，这些变异型可能代表恶性肿瘤的潜在诊断陷阱，尤其是在评估粗针穿刺活检时。在这方面，将介绍以下肌成纤维细胞瘤的变异型，包括最近发现的变异型：黏液样肌成纤维细胞瘤、脂肪瘤样肌成纤维细胞瘤、上皮样细胞肌成纤维细胞瘤、蜕膜样细胞肌成纤维细胞瘤、具有多结节生长模式的上皮样细胞肌成纤维细胞瘤、栅栏状/神经鞘样肌成纤维细胞瘤以及伴有广泛黏液性水肿性间质改变的肌成纤维细胞瘤。将提供组织学插图以及每种肌成纤维细胞瘤变异型的鉴别诊断问题，以便为日常实践中的正确诊断方法提供有益建议。
