Postoperative spindle cell nodule of the breast: Pseudosarcomatous myofibroblastic proliferation following endo-surgery

Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, Santander, Spain.
Pathology International (Impact Factor: 1.69). 01/2009; 58(12):787-91. DOI: 10.1111/j.1440-1827.2008.02312.x
Source: PubMed


Despite the frequent use of fine-needle aspiration, core biopsy and surgery, postoperative spindle cell nodule (PSCN) is a rare pathological complication that may be diagnostically treacherous. Presented herein is the case of a 52-year-old woman who developed a 7 mm mammary nodular lesion 66 days after removal of an area of columnar cell hyperplasia involving cellular and architectural atypia, performed with the Mammotome Breast Biopsy System. The lesion was highly cellular and composed of intersecting fascicles of plump spindle cells with blunt-ended elongated nuclei and nucleoli easily visible. Interspersed mononuclear cells and hemosiderin-laden macrophages were evident. PSCN is a reactive, benign myofibroblastic proliferation. Differential diagnosis includes benign and malignant spindle cell lesions of the breast. Recognition of this reactive lesion will avoid overdiagnosis of spindle cell malignant tumor. Attention to clinicopathological and histological features should result in accurate recognition of this lesion.

2 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Exuberant reparative reactions resembling sarcoma have been reported in the genitourinary tract, thyroid, breast, lymph node, oral cavity and skin, but not in a varicose vein. Presented herein is the case of a 55-year-old man who showed an incidental nodular lesion in the wall of a varicose vein on the left leg. The nodule consisted of fascicles of spindled cells with ovoid or elongated nuclei and delicate chromatin that showed diffuse reactivity for CD31, alpha-smooth muscle actin and D2-40. This histopathological appearance, when coupled with extravasated erythrocytes and interstitial hemosiderin deposits, resembled Kaposi's sarcoma or spindle cell angiosarcoma. Key features helpful for recognizing that the proliferation we describe is a form of tissue repair include an association with obvious hemorrhage; lack of well-formed curved fascicles of spindled cells; lack of intracytoplasmic hyaline globules; lack of intracellular vacuolization; cytological blandness; low mitotic count; absence of inmmunoreactivity for human herpesvirus-8 (HHV-8) latent nuclear antigen-1; and absence of HHV-8 in polymerase chain reaction (PCR) analysis. Val-Bernal JF, Val D, Garijo MF, Gómez-Román JJ. Nodular spindle cell proliferation in the wall of a varicose vein mimicking Kaposi's sarcoma.
    No preview · Article · Apr 2010 · Journal of Cutaneous Pathology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fasciitis-like proliferations are said to be uncommon in the viscera; a fasciitis-like pattern of gallbladder injury may not be rare, but to our knowledge it has not been explicitly reported as such in any age group. Osseous metaplasia, or heterotopic bone, in the gallbladder is rare and has not to our knowledge been reported in a pediatric patient. We report a 7-year-old boy with sickle cell disease who presented with right upper quadrant abdominal pain. An ultrasonograph demonstrated a dilated common bile duct with sludge and stones. A cholecystectomy was performed. Grossly the gallbladder showed numerous pigmented choleliths, and histologically there was cholecystitis with a fasciitis-like fibrous proliferation containing scattered osteoclast-like giant cells and an area of osseous metaplasia. This report, describing a pattern that could be termed "cholecystitis ossificans," expands the histologic spectrum of chronic cholecystitis, a common disease with a poorly understood pathogenesis.
    No preview · Article · May 2010 · Pediatric and Developmental Pathology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Breast tumors are the most common tumors of epithelial origin. Some tumors or tumor-like lesions of the breast may display a morphology similar to mesenchymal tumors predominated by spindle cells. However, such morphology is apt to be confused with others due to lack of the characteristic histopathology. This paper reviews some spindle cell lions in the breast, in an attempt to provide theoretical evidences for the differentiation diagnosis of breast tumors and tumor-like lions.
    No preview · Article · Jan 2011 · Academic Journal of Second Military Medical University
Show more