Zhou Peng, Chen Yi-Hao, Lu Jiang-Hao, Jin Chun-Chun, Xu Xiao-Hong, Gong Xue-Hao
Department of Ultrasound, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China.
Graduate School, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China.
World J Clin Cases. 2022 Feb 6;10(4):1432-1440. doi: 10.12998/wjcc.v10.i4.1432.
Inflammatory myofibroblastic tumors (IMTs) are defined as tumors composed of differentiated myofibroblastic spindle cells, usually accompanied by numerous plasma cells and lymphocytes, and classified as intermediate (occasionally metastatic) by the World Health Organization. Its pathogenesis and biological behavior have not yet been elucidated. Breast IMT is extremely rare, and prosthesis implantation combined with IMT has not been reported. This study reports a case of IMT following resection of a malignant phyllodes tumor of the left breast and implantation of a prosthesis.
A 41-year-old female presented to our hospital with a mass in the left breast for 3 mo. The patient had undergone resection of a large mass in her left breast pathologically diagnosed as a malignant phyllodes tumor and implantation of a prosthesis five years prior. Ultrasonic examination revealed an oval mass in the left breast, and the patient underwent left breast mass resection and prosthesis removal. Light microscopy revealed the spindle cells to be diffusely proliferated, with a large number of neutrophils, lymphocytes, and plasma cell infiltration. Immunohistochemical staining revealed that the spindle cells were partially positive for smooth muscle actin, which is positive for BCL-2 and cluster of differentiation (CD) 99 but were negative for anaplastic lymphoma kinase, cytokeratin, S-100 protein, desmin, and CD34. The final diagnosis was IMT. No recurrence or metastasis was observed during the 5-year postoperative follow-up.
Prosthesis implantation may be one of the causes of IMT, but further investigation is necessary to prove it.
炎性肌纤维母细胞瘤(IMTs)被定义为由分化的肌纤维母细胞性梭形细胞组成的肿瘤,通常伴有大量浆细胞和淋巴细胞,世界卫生组织将其分类为中间型(偶尔转移)。其发病机制和生物学行为尚未阐明。乳腺IMT极为罕见,且假体植入合并IMT的情况尚未见报道。本研究报告1例左乳恶性叶状肿瘤切除及假体植入后发生IMT的病例。
一名41岁女性因左乳肿物3个月就诊于我院。患者5年前曾行左乳巨大肿物切除,病理诊断为恶性叶状肿瘤并植入假体。超声检查显示左乳有一椭圆形肿物,患者接受了左乳肿物切除及假体取出术。光镜下可见梭形细胞弥漫性增生,有大量中性粒细胞、淋巴细胞及浆细胞浸润。免疫组化染色显示梭形细胞平滑肌肌动蛋白部分阳性,BCL-2及分化簇(CD)99阳性,但间变性淋巴瘤激酶、细胞角蛋白、S-100蛋白、结蛋白及CD34阴性。最终诊断为IMT。术后5年随访未观察到复发或转移。
假体植入可能是IMT的病因之一,但尚需进一步研究证实。