Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
Department of Surgery, Royal Columbian Hospital, New Westminster, BC, Canada.
J Clin Pathol. 2019 Jun;72(6):438-442. doi: 10.1136/jclinpath-2018-205561. Epub 2019 Feb 9.
Benign spindle cell lesions of the breast include neoplastic and reactive entities that are diagnostically challenging given their rarity and similar histomorphology. Accurate diagnosis on percutaneous core biopsy within this category is essential as some lesions require excision and surveillance, whereas others may be observed. We present three cases of rare benign spindle cell lesions of the breast that reflect the diversity of this group: solitary fibrous tumour, nodular pseudoangiomatous stromal hyperplasia and nodular fasciitis. Through these cases, we discuss the associated differential diagnosis and demonstrate how emerging ancillary studies can be integrated into a diagnostic approach. We highlight distinctive clinical and histopathological features and summarise recent updates to the clinical management of these lesions. An organised approach to the broad differential of spindle cell lesions is essential for appropriate diagnosis and treatment.
乳腺良性梭形细胞病变包括肿瘤性和反应性病变，由于其罕见性和相似的组织形态学特征，诊断具有挑战性。在经皮核心活检中对这一类别进行准确诊断至关重要，因为一些病变需要切除和监测，而另一些病变则可以观察。我们介绍了三种罕见的乳腺良性梭形细胞病变，反映了这一组病变的多样性：孤立性纤维瘤、结节状假血管瘤样间质增生和结节性筋膜炎。通过这些病例，我们讨论了相关的鉴别诊断，并展示了如何将新兴的辅助研究纳入诊断方法。我们强调了独特的临床和组织病理学特征，并总结了这些病变临床管理的最新进展。对梭形细胞病变广泛差异的有组织的方法对于正确的诊断和治疗是必要的。
