Unusual Histopathology in Malignant Phyllodes Tumours Causing Diagnostic Difficulties in Cytology: A Retrospective Study
Journal Title: International Journal of Medical Research Professionals - Year 2018, Vol 4, Issue 3
Abstract
Introduction: Phyllodes tumour of breast, previously designated as “Cystosarcoma Phylloides,” later classified as “Benign” or “Malignant” according to their histologic appearance and beheaviour. Varied Stromal changes like lipomatous, osseous, cartilaginous, myosarcomatous, angiosarcomatous and epithelial changes like apocrine and squamous metaplasia are observed in benign and malignant counterparts. Though FNAC is the first line of diagnosis in breast neoplasm, but rare unusual pattern may limit the cytological diagnosis and necessitate the histopathological final conclusion. Methods: Nine cases with final histopathological diagnosis of Malignant Phyllodes, based on morphology alone, in last four years are retrieved and studied vigorously for evaluation of cytological pitfalls in such lesions. Results: All cases of this study are female ranging from 45- 54 yrs and having huge mass in one breast without any axillary lymph nodes. 33.3% (n=3) cases were cytologic category 5 (Malignant), but the cytological diagnosis was not corroborated on histology. Cytology of 22.2% (n=2) reported as category 4(suspicious of malignancy), with incorrect provisional diagnosis of Borderline Phyllodes. 11.1% (n=1) case reported on cytology as Category 3 (Atypical probably benign) due to extensive squamous metaplasia obscuring underlying chondrosarcomatous differentiation. Another two(22.2%) was Inadequate for opinion in cytology (CategoryC1) due to repeated hemorrahagic aspirate from different sites which was due to specific stromal changes in the phyllodes stroma. Conclusion: Unusual stromal component with lack of epithelial component and/ or metaplasia of epithelial component may lead to improper erroneous cytologic evaluation, particularly in huge breast masses.
Authors and Affiliations
Bandyopadhyay Goutam, Mukhopadhyay Sabuj Ghana, Raina Rimjhim
Keywords
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- EP ID EP531846
- DOI 10.21276/ijmrp.2018.4.3.018
- Views 70
- Downloads 0
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