Falconieri G, Della Libera D, Zanconati F, Bittesini L
Division of Anatomic Pathology, City Hospital, Conegliano TV, Italy.
Am J Clin Pathol. 1997 Jul;108(1):19-25.
We present the clinical, light microscopic, and immunohistochemical features of two new cases of leiomyosarcoma of the female breast. Both the patients were old (83 and 86 years) and were referred with a history of a long-standing breast lump. The results of the physical examination and the preoperative radiologic investigations suggested a phyllodes tumor. The patients were treated with mastectomy. The tumors measured 6 and 6.5 cm in the largest dimension, respectively, and were composed of fascicles of atypical, actively proliferating spindle cells, often intersecting at right angles. The axillary lymph nodes were free of tumor. Immunohistochemically, the tumor cells were positive for desmin, muscle-specific actin, and vimentin and negative for other markers, including keratins and hormone receptors. Focal rhabdomyoblastic differentiation was noted in one case. Follow up at 1 year is negative for metastases or local recurrences. Our study confirms that leiomyosarcoma of the breast is a locally invasive neoplasm and that it could represent a peculiar anatomic entity among mesenchymal tumors of the breast.
我们报告了两例女性乳腺平滑肌肉瘤新病例的临床、光学显微镜和免疫组织化学特征。两名患者均为老年女性（分别为83岁和86岁），因长期存在乳腺肿块前来就诊。体格检查和术前影像学检查结果提示为叶状肿瘤。两名患者均接受了乳房切除术。肿瘤最大直径分别为6厘米和6.5厘米，由非典型的、活跃增殖的梭形细胞束组成，这些细胞束常呈直角相交。腋窝淋巴结无肿瘤转移。免疫组织化学检查显示，肿瘤细胞结蛋白、肌特异性肌动蛋白和波形蛋白呈阳性，而其他标志物包括角蛋白和激素受体呈阴性。其中一例可见局灶性横纹肌母细胞分化。随访1年未见转移或局部复发。我们的研究证实，乳腺平滑肌肉瘤是一种局部侵袭性肿瘤，并且它可能代表乳腺间叶性肿瘤中的一种特殊解剖实体。
