Talwar Amrita, Jain Swasti, Ahuja Arvind, Paliwal Purnima
Department of Pathology, ABVIMS and Dr. RML Hospital, New Delhi, India.
Indian J Surg Oncol. 2021 Apr;12(Suppl 1):201-204. doi: 10.1007/s13193-021-01294-9. Epub 2021 Mar 2.
Epithelioid myofibroblastoma of the breast is a rare benign stromal tumor occurring in the postmenopausal females and elderly males. We report one such case in a 65-year-old female who underwent trucut biopsy from a well-defined right breast lump, which was misinterpreted as invasive lobular carcinoma on histology. Tumor showed mild to moderately pleomorphic tumor cells arranged in single file pattern, loosely dispersed and focally in sheets with inconspicuous nucleoli embedded in a fibrotic and hyalinized stroma. Immunohistochemistry for E-cadherin was negative further substantiating the morphological diagnosis. However, mastectomy specimen revealed it to be a case of epithelioid myofibroblastoma with the help of a large panel of immunohistochemical stains. In this report, we emphasize on the challenges of establishing this rare diagnosis mimicking lobular carcinoma, a diagnostic pitfall on trucut biopsy.
乳腺上皮样肌成纤维细胞瘤是一种罕见的良性间质肿瘤，发生于绝经后女性和老年男性。我们报告一例65岁女性病例，该患者对一个边界清晰的右乳肿块进行了粗针活检，组织学检查时被误诊为浸润性小叶癌。肿瘤显示轻度至中度多形性肿瘤细胞呈单行排列，松散分布，局部呈片状，核仁不明显，包埋于纤维化和玻璃样变的间质中。E-钙黏蛋白免疫组化结果为阴性，进一步证实了形态学诊断。然而，乳房切除术标本在大量免疫组化染色的帮助下显示为上皮样肌成纤维细胞瘤病例。在本报告中，我们强调了建立这种罕见诊断（酷似小叶癌）所面临的挑战，这是粗针活检中的一个诊断陷阱。
