Epithelioid leiomyoma of the breast with granular cell change: A case report

Institutes of Anatomic Pathology and Electron Microscopy, University of Bologna, Bologna, Italy
Human Pathlogy (Impact Factor: 2.77). 12/1993; 24(11):1260-1263. DOI: 10.1016/0046-8177(93)90225-6


A 42-year-old woman with an epithelioid granular cell leiomyoma of the right breast is reported. The cells were spindle to polygonal and displayed finely granular cytoplasm. The smooth muscle differentiation of this tumor was shown by the immunohistochemical positivity of the neoplastic cells with anti-alpha smooth actin and anti-desmin antisera. Microfilaments with focal densities were present in the cytoplasm at an ultrastructural level. The granular cytoplasmic changes are related to a relevant number of lysosomes within the neoplastic cells.

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    ABSTRACT: REV ESP PATOL 12. Gusterson BA, Gelber RD, Goldhirsh Aet al. Prognostic significance of c-erbB-2 expression in breast cancer. J Clin Oncol 1992; 10:1049-1056. 13. Muss HB, Thor AD, Berry DA et si. c-erbB-2 expression and response to adju-vant therapyin women with node positive breast cancer. N Engl J Med 1994; 330:1309-1310. 14. Resnick JM, Sneige N, Kemp BL et al. p53 and c-erbB-2 expression and response to preoperative chemotherapy in locally advancedbreast carcinoma. Breast Dis 1995; 8:149-158. 15. Barnes DM. c-erbB-2 amplification in mammary carcinoma. In recent years, more attention has been paid to breast tumors dis-playing granular cytoplasm. This granular aspect is variable depend-ing on the different organelles of which it is constituted, such as mito-chondria, secretory products, or lysosomes. Oncocytomas (oncocytic carcinomas) were recently described by Damiani et al. (1). Most of these lesions have low-grade nuclei and show eosinophilic granular cytoplasm. Antimitochondrium anti-body is strongly positive, while the apocrine markers are frequently negative. At ultrastructure these lesions show numerous enlarged mitochondria scattered throughout the cytoplasm. Secretory gran-ules, when present, are located at one pole of the cell. In recent years we have seen grade Ill DCI cases loaded with mitochondria as well as myoepithelial cell carcinomas with oncocytic changes. This latter type of tumor is easily overlooked in the breast. An acinic cell carcinoma of the breast have been described by Roncaroli et al. (2) as a single case report. Since then we have seen a number of tumors with a distinct morphology (similar to that seen in acinic cell carcinoma of salivary glands) and in which sali-vary gland amylase and lysozyme showed immunocytochemical positivity. Lysosome rich cells have been seen in leiomyoma of the breast which is a rare lesion, newly described by Roncaroli et al. (3). Adenohibernoma (4) is a benign lesion that has to be recognized in order to avoid erroneous diagnoses of malignancy such as in the cases of solitary fibrous tumors (5). In contrast low-grade adeno-squamous carcinomas which look like benign lesions and otten inter-preted as scierosing adenosis, show a locally aggressive attitude and frequent lymph node metastases (6).
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    ABSTRACT: Duringthe last decades,increasingattentionhasbeenfocusedon the roleof extracellularmatrix,especiallybasementmembrane,in the processof tumorinvasionand metastasis.Althoughthe bio- chemicalmechanismsinvolvedin basementmembraneturnover underphysiologicalconditionsremainessentiallyunknown,it has beenestablishedthat the basementmembrane-degrading proper- tiesof tumorcellscorrelatewiththeirmetastaticpotential.Degrada- tionof extracellular matricesisa fundamental stagein theprocessof invasion andthedevelopment of metastasis. Matrix metalloproteinases (MMPs)are a group of proteolytic enzymes withcapacityto degradeandremodelthe components of theextracellular matrix.TheseMMPsincludecollagenases, gelati- nases,stromelysinsand others. The activity of these enzymes dependson manyfactors, includingthe presenceof specificin- hibitorsof metalloproteinases or TIMPs.
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    ABSTRACT: Nine smooth muscle tumours, arising at a variety of sites and showing granular cell change of their cytoplasm, have been studied morphologically and immunohistochemically. The age of the patients ranged from 6 to 78 years (median 42 years); seven patients were female. Two tumours each arose in the dermis or subcutaneous tissue while the other five cases were situated in deeper soft tissue. Three of the lesions arose in the lower limbs, two in the pelvis and one each in the regions of the elbow, shoulder, breast and buttock. Follow-up in eight patients was available and revealed local recurrence in three and pulmonary metastases in two cases. All cases showed at least focally the light microscopic features of a smooth muscle tumour and demonstrated moderate to strong positivity for alpha-smooth muscle actin. Five were also HHF-35 positive and three were desmin positive. Noteworthy was strong positivity for the 'melanoma associated' antigen NKI/C3 in all cases. Six cases stained also weakly positive for NSE, but all were S-100 protein negative. The former is not specific but is the most reliable marker of lesions showing granular cell change. Granular cytoplasmic change represents simply a cytological phenotype, apparently representing a characteristic metabolic alteration, not exclusively associated with Schwann cell tumours. Tumours containing granular cells are best classified according to their line of specific cellular differentiation if possible.
    Histopathology 04/1994; 24(3):223-31. DOI:10.1111/j.1365-2559.1994.tb00514.x · 3.45 Impact Factor
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