Moghimi Mansour, Yazdian Anari Pouria, Vaghefi Marzie, Meidany Abbas, Salehi Heidar
Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Medical Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Iran J Radiol. 2016 Jan 30;13(1):e18774. doi: 10.5812/iranjradiol.18774. eCollection 2016 Jan.
Nodular fasciitis of the breast is a rare benign pathology of soft tissue that is a consequence of fibroblastic hyperplasia within breast. It can mimic breast cancer clinically, radiologically, and histopathologically. A-43 year-old female with a painless mass within upper-lateral quadrant of her left breast complained of rapid and progressive growth during previous few days. No evidence of nipple discharge or sensation of pain was expressed. The mass was tender to palpation, but the size was too tiny to detect. The definitive diagnosis was established with sonography, which detected a hypoechogenic lesion, 10 mm in diameter. The excisional biopsy delivered a tissue composed of fusiform fibroblastic cells with bright ellipsoid-like nuclei and elevated nucleolus. Mitotic formations were also obvious. Low cellular and high cellular zones with hyaline fibrosis and erythrocyte accumulation existed, as well as a light lymphocytic infiltration. All of these features, in addition to adipocytic accumulation within the margins of this lesion, suggested a definitive diagnosis of Nodular fasciitis. The diagnosis of nodular fasciitis is difficult and often is indiscriminable from breast cancer, so paying close attention to this matter is critical.
乳腺结节性筋膜炎是一种罕见的软组织良性病变,是乳腺内纤维母细胞增生的结果。它在临床、放射学和组织病理学上都可能与乳腺癌相似。一名43岁女性,左乳房外上象限有一无痛性肿块,她主诉在过去几天里肿块迅速且持续增大。没有乳头溢液或疼痛感觉的迹象。肿块触诊时有压痛,但尺寸太小难以察觉。通过超声检查确诊,超声检测到一个直径10毫米的低回声病变。切除活检得到的组织由梭形纤维母细胞组成,细胞核呈明亮的椭圆形,核仁增大。有丝分裂形态也很明显。存在低细胞区和高细胞区,伴有透明样纤维化和红细胞聚集,还有轻度淋巴细胞浸润。除了病变边缘有脂肪细胞聚集外,所有这些特征都提示确诊为结节性筋膜炎。结节性筋膜炎的诊断很困难,而且常常难以与乳腺癌区分,因此密切关注此事至关重要。