Villasmil-Araujo V
Cátedra de Anatomía Patológica, Escuela de Medicina, Facultad de Medicina, Universidad del Zulia, Maracaibo, Venezuela.
Invest Clin. 1993;34(4):163-79.
The present study compares the biological behavior of a phyllode tumors to its histological characteristics. Traditional concepts are still valid since 100% of the tumors with severe atipicity recurred, while 76.9% of those with minimal atipicity did not. In certain cases, histological details provided the explanation for the evolution of the tumor. On those recurs cases with minimal atipicity 66.6% were treated with conservative surgery, probably with insufficient removal of healthy tissue to ensure that no tumor was left. No histological explanation was found for the rest of recurrences. However, they could be caused by the tendency of the tumor to grow with the same histological elements in multiple areas of the same or the opposite mammary gland. As previously demonstrated by other authors, the prognostic importance of the search for other histological features, such as number of mitosis, microscopical margins of the tumor, stromal overgrowing, necrosis, appearance of the epithelial component and the area with the most cellularity. It is suggested that all these features should be determined in each case of the phyllodes tumor.
本研究比较了叶状肿瘤的生物学行为与其组织学特征。传统观念仍然有效,因为100%具有严重异型性的肿瘤复发,而76.9%具有最小异型性的肿瘤未复发。在某些情况下,组织学细节解释了肿瘤的演变。在那些具有最小异型性的复发病例中,66.6%接受了保守手术治疗,可能是因为切除的健康组织不足,无法确保没有残留肿瘤。其余复发病例未发现组织学解释。然而,它们可能是由于肿瘤倾向于在同一乳腺或对侧乳腺的多个区域以相同的组织学成分生长所致。正如其他作者先前所证明的,寻找其他组织学特征,如有丝分裂数量、肿瘤的显微镜下边缘、间质过度生长、坏死、上皮成分的外观以及细胞最密集的区域,具有预后重要性。建议在每例叶状肿瘤病例中都应确定所有这些特征。