1.Giant Myofibroblastoma of the Male Breast: A Case Report and Literature Review
Kamal Kataria ; Anurag Srivastava ; Lavleen Singh ; Vaishali Suri ; Rajni Yadav
Malaysian Journal of Medical Sciences 2012;19(3):74-76
Myofibroblastomas are soft-tissue neoplasms that are thought to arise from myofibroblasts. They are mostly observed in males 41–85 years of age; however, this lesion also occurs in women. The usual clinical presentation is a unilateral painless lump that is not adherent to overlying or underlying structures. Microscopically, myofibroblastomas can be divided into 5 subtypes: classical, epithelioid, collagenised, cellular, and infiltrative. Mammary ducts and lobules are absent in the typical histological subtypes and the adjacent breast parenchyma may form a pseudocapsule. The majority of myofibroblastomas are immunoreactive for CD34, desmin, smooth muscle actin, and vimentin and are negative for cytokeratin and S-100 protein. We present a case of a giant myofibroblastoma arising in the background of gynecomastia in an adult male.
2.Myeloid sarcoma of the breast in an aleukemic patient:a rare entity in an uncommon location
Aasma Nalwa ; Devajit Nath ; Vaishali Suri ; Mohamed Amjad Jamaluddin ; Anurag Srivastava
The Malaysian Journal of Pathology 2015;37(1):63-66
Myeloid sarcoma (MS) is an extramedullary solid neoplasm of immature myeloid cells. These tumours
usually develop in concurrence with or following acute leukemia. The breast is an uncommon site
for presentation of this tumour, where it is often misdiagnosed as lymphoma or carcinoma.A 33-
year-old female presented with a right breast lump in a private hospital, which was diagnosed as
ductal carcinoma on lumpectomy. Subsequently she developed a lump in the left breast and a similar
diagnosis of carcinoma was made on biopsy. A left mastectomy was performed. Histopathological
examination revealed a tumour composed of mononuclear cells arranged in sheets and cords with
round to oval vesicular nuclei and occasional prominent nucleoli. IHC for CK was very weak and
focal. The tumour cells were immunonegative for ER, PR, Her2neu,epithelial membrane antigen,
e-cadherin, CD3 and CD20. Diffuse immunopositivity for myeloperoxidase, CD34 and CD117
established a diagnosis of myeloid sarcoma. A histopathological review of the right breast lesion,
with immunohistochemistry, also confirmed the diagnosis of myeloid sarcoma. Investigatory workup
for acute myeloid leukemia, including bone marrow aspirate and biopsy and karyotypic studies,
proved negative. The patient was treated with high dose cytarabine (HDAC) regimen and was disease
free during the 12-month follow-up.Although extremely rare, awareness of such a presentation is
crucial. This case also illustrates that careful histopathological review along with an expanded panel
of immunohistochemistry is extremely important for recognizing such cases as a misdiagnosis can
lead to unnecessary surgery and inappropriate therapy.