Male Breast Cellular Myofibroblastoma With a Rich Reticulinic Network: Case Report

University of Medicine and Pharmacy, Targu-Mures, Romania.
American journal of men's health (Impact Factor: 1.15). 03/2012; 6(4):344-8. DOI: 10.1177/1557988312441817
Source: PubMed


Myofibroblastoma is a rare mesenchymal tumor located not only in breast but also in extramammary sites. This is the 79th case of breast myofibroblastoma reported in the literature. This tumor presents a great variety of morphological features, which increase the difficulty of differential diagnosis. The authors report a breast myofibroblastoma diagnosed in a 73-year-old male. The article discusses a bilateral gynecomastia and a palpable right breast well-defined tumor, without calcifications on mammography, which was surgically removed. Macroscopically, a well-circumscribed uncapsulated nodule was seen with lobular arrangement on cut section, and microscopically, a nodule with pushing borders and a connective pseudocapsule was seen. The spindle cells were arranged in fascicular clusters, with focally collagen bundles and a rich reticulinic network stained black with Gömöri impregnation. Immunohistochemically, the tumor cells were marked by vimentin, CD34, desmin, and smooth muscle antigen and did not express cytokeratin, S-100 protein, CD99, CD10, and factor VIII-related antigen. More than 90% of the cells expressed estrogen receptor. No recurrences were reported 2 years after surgical excision. This case is a variant of cellular myofibroblastoma, with a rich reticulinic network and scanty collagen bands.

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    • "SMA is a usual marker used for differential diagnosis of several tumors. Beside smooth muscle fibers, it also marks the fibroblasts and myofibroblasts being overexpressed in some mesenchymal tumors such as leiomyoma, leimyosarcoma, myofibroblastoma, inflammatory myofibroblastic tumor, and gastrointestinal stromal tumors with myogenic differentiation [11], [12], [15]. A slight expression of SMA was also reported in spindle-shaped KS cells [7], [16], but its significance was not elucidated yet. "
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    ABSTRACT: Although several studies have been conducted regarding Kaposi sarcoma (KS), its histogenesis still remains to be elucidated. The aim of our study was to analyze the immunophenotype of Kaposi sarcoma and to present a hypothesis about the histogenesis of this tumor, based on a case series and a review of relevant literature. In 15 cases of KSs diagnosed during 2000-2011, the clinicopathological features were correlated with the immunoexpression of c-Kit, SMA, CD34, CD31, vascular endothelial growth factor (VEGF), COX-2, c-KIT, smooth muscle antigen (SMA), and stem cell surface marker CD105. Both CD105 and c-KIT rate of the spindle-shaped tumor cell positivity increased in parallel to the pathological stage. All cases displayed CD105 and weak c-KIT positivity in the endothelial cells. SMA, VEGF, and COX-2 were focally expressed in all cases. CD34 marked both endothelium and spindle-shaped tumor cells. No c-KIT expression was noticed in KS of the internal organs. KS seems to be a variant of myofibroblastic tumors that originates from the viral modified pluripotent mesenchymal cells of the connective tissue transformed in spindle-shaped KS cells, followed by a mesenchymal-endothelial transition and a myofibroblastic-like differentiation. This paper mailnly showed that KS cannot be considered a pure vascular tumor.
    Full-text · Article · Aug 2013 · PLoS ONE
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    Preview · Article · Jan 2013 · Journal of Clinical Oncology
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    ABSTRACT: Myofibroblastoma of the breast (MFB) is a rare benign tumor of mesenchymal origin with only 80 cases reported in the literature so far. It most commonly occurs in elderly males and postmenopausal females and grows slowly over a period of months to years. In this study we describe a very rare case of a MFB in a premenopausal woman who presented with a rapidly growing breast mass. Diagnostic evaluation and management of the patient are discussed along with a review of the literature. We conclude that despite its rarity, myofibroblastoma should always be considered in the differential diagnosis of mesenchymal breast tumors. No specific imaging features have been described. Thorough immunohistochemical analysis is crucial to obtain a definitive diagnosis. Local excision is the treatment of choice.
    No preview · Article · Apr 2013 · Breast disease
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