유방 엽상종양의 세포조직학적 비교분석 - 17예에 대한 연구 -
Cytohistologic Correlation of Phyllodes Tumors of the Breast - A Study on 17 Cases -
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Phyllodes tumor (PT) is a rare fibroepithelial tumor of the breast, and these tumors are subdivided into benign, borderline, and malignant tumors. The criteria for their histologic diagnosis have been relatively well-described. However, the cytologic diagnosis presents more difficulties and only a few cytologic studies concerned with their subclassification have been published. The objective of the current study is to describe the cytologic features of benign, borderline and malignant PTs in an attempt to distinguish one from the others. Cytohistologic correlation for 11 benign, 3 borderline and 3 malignant PTs was performed. For all these cases, the preoperative fine needle aspiration (FNA) findings were available for review. The features we examined were a necrotic background, cellularity, stromal tissue fragments, stromal pleomorphism and atypism, dissociated stromal cells and mitosis. The overall diagnostic accuracy of FNA for the PT grading was 88.2% (15/17). Two benign PTs were cytologically misinterpreted as ‘‘atypical epithelial and stromal cells’’ and ‘‘highly suspicious for ductal carcinoma’’. Nevertheless, the cytologic diagnosis and the grading of PTs on FNA were relatively reliable. Semiquantitative analysis for the cellular stromal tissue fragments, stromal pleomorphism and atypism, dissociated stromal cells and mitosis might be helpful for subclassifing PTs on FNA. In the case of encountering a markedly necrotic background, special concern about degenerative change such as infarction is needed.
Abstract
Phyllodes tumor (PT) is a rare fibroepithelial tumor of the breast, and these tumors are subdivided into benign, borderline, and malignant tumors. The criteria for their histologic diagnosis have been relatively well-described. However, the cytologic diagnosis presents more difficulties and only a few cytologic studies concerned with their subclassification have been published. The objective of the current study is to describe the cytologic features of benign, borderline and malignant PTs in an attempt to distinguish one from the others. Cytohistologic correlation for 11 benign, 3 borderline and 3 malignant PTs was performed. For all these cases, the preoperative fine needle aspiration (FNA) findings were available for review. The features we examined were a necrotic background, cellularity, stromal tissue fragments, stromal pleomorphism and atypism, dissociated stromal cells and mitosis. The overall diagnostic accuracy of FNA for the PT grading was 88.2% (15/17). Two benign PTs were cytologically misinterpreted as ‘‘atypical epithelial and stromal cells’’ and ‘‘highly suspicious for ductal carcinoma’’. Nevertheless, the cytologic diagnosis and the grading of PTs on FNA were relatively reliable. Semiquantitative analysis for the cellular stromal tissue fragments, stromal pleomorphism and atypism, dissociated stromal cells and mitosis might be helpful for subclassifing PTs on FNA. In the case of encountering a markedly necrotic background, special concern about degenerative change such as infarction is needed.
참고문헌 (17)
- Tavassoli FA, "WHO classification of tumors; pathology and genetics of tumours of the breast and female genital organs", pp.100~103 (2003), IARC Press
- Page DL, "Diagnostic histopathology of the breast", pp.341~350 (1987), Churchill Livingstone
- Harris JR, "Diseases of the breast", pp.863~869 (1996), Lippincott-Raven Publishers
- Rosen PP, "Fibroepithelial tumors. in: Rosen’s breast pathology", pp.155~171 (1997), Lippincott-Raven
- Pietruszka M, "Cystosarcoma phyllodes: a clinicopathologic analysis of 42 cases", Cancer, 41, pp.1974~1983 (1978)
- Harris JR, "Diseases of the breast", pp.863~869 (1996), Lippincott-Raven Publishers
- Salvadori B, "Surgical treatment of phyllodes tumors of the breast", Cancer, 63, pp.2532~2536 (1989)
- Koss LG, "Aspiration biopsy: Cytologic interpretation and histologic bases", pp.141~ (1992), Igaku-Shoin Inc
- Shimizu K, "Cytologic evaluation of phyllodes tumors as compared to fibroadenomas of the breast", Acta Cytol, 36, pp.215~221 (1992)
- Shabb NS, "Phyllodes tumor: fine needle aspiration cytology of eight cases", Acta Cytol, 41, pp.321~326 (1997)
- Dusenbery D, "Fine needle aspiration cytology of phyllodes tumor. Potential diagnostic pitfalls", Acta Cytol, 36, pp.215~221 (1992)
- Rao CR, "Cystosarcoma phyllodes: diagnosis by fine needle aspiration cytology", Acta Cytol, 36, pp.203~207 (1992)
- Bhattarai S, "Phyllodes tumor of the breast. A Cytohistologic study of 80 cases", Acta Cytol, 44, pp.790~796 (2000)
- Jayaram G, "Fine-needle aspiration cytology of phyllodes tumors", Diagn Cytopathol, 26, pp.222~227 (2002)
- Suh JH, "Cytologic features of benign phyllodes tumors as compared to fibroadenomas of the breast", Korean J Cytopathol, 7, pp.151~156 (1996)
- Veneti S, "Benign phyllodes tumour vs fibroadenoma:FNA cytological differentiation", Cytopathology, 12, pp.321~328 (2001)
- Verslegers I, "Massive infarction of a recurrent phyllodes tumor of the breast; MRI-findings", JBR-BTR, 87, pp.21~22 (2004)