Kobayashi N, Oda K, Yokoi S, Kanda H, Hayakawa S, Tang X, Osamura Y
Department of Surgery, Anjo Kosei Hospital, Aichi, Japan.
Surg Today. 1996;26(9):727-9. doi: 10.1007/BF00312094.
We report herein the case of a 36-year-old woman in whom a breast mass was diagnosed histologically and immunohistochemically as myofibroblastoma (MFB). The patient initially presented with a breast mass measuring 1.0 x 1.5 cm which was demonstrated by mammography as a well-circumscribed, round tumor with two coarse calcifications. On ultrasonography, the tumor showed slight shadowy internal echoes. Histological examination of an excisional biopsy specimen demonstrated a tumor consisting of spindle-shaped cells and broad bands of hyalinized collagen with cartilaginous and osseous components, but no epithelial components were observed. Immunohistochemically, the tumor cells were diffusely positive for alpha smooth muscle actin, and a diagnosis of MFB was made. A wide excision of the breast was performed as a secondary procedure, and the patient is well and free from recurrence 1 year after her operation. We present this case to stress the need for breast surgeons to be aware of the existence of MFB when considering the differential diagnosis of stromal lesions of the breast to avoid performing unnecessarily extensive procedures.
我们在此报告一例36岁女性病例，其乳腺肿块经组织学和免疫组织化学检查诊断为肌纤维母细胞瘤（MFB）。患者最初表现为一个大小为1.0×1.5 cm的乳腺肿块，乳房X线摄影显示为边界清晰的圆形肿瘤，伴有两处粗大钙化。超声检查显示肿瘤内部回声略有模糊。切除活检标本的组织学检查显示肿瘤由梭形细胞和宽束状透明化胶原组成，伴有软骨和骨成分，但未观察到上皮成分。免疫组织化学检查显示肿瘤细胞α平滑肌肌动蛋白弥漫性阳性，诊断为MFB。作为二期手术进行了乳房广泛切除，患者术后1年情况良好，无复发。我们展示此病例以强调乳腺外科医生在考虑乳腺间质病变的鉴别诊断时需要意识到MFB的存在，以避免进行不必要的广泛手术。
