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Stromal sarcoma of the breast with leiomyosarcomatous pattern
Author(s) -
Kusama Ritsu,
Fujimori Minoru,
Hama Yoshihisa,
Shingu Kiyoshi,
Ito Kenichi,
Mochizuki Yasuhiro,
Yamanda Ken,
Matsuyama Ikuo,
Tsuchiya Shinichi,
Amano Jun
Publication year - 2002
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1046/j.1440-1827.2002.01386.x
Subject(s) - stromal cell , pathology , desmin , vimentin , cytokeratin , basal lamina , myoepithelial cell , multinucleate , intermediate filament , biology , leiomyosarcoma , sarcoma , immunohistochemistry , medicine , cell , ultrastructure , cytoskeleton , genetics
We report an unusual case of stromal sarcoma of the breast with leiomyosarcomatous pattern, which recurred locally and was finally treated by radical mastectomy. The tumor was composed of pleomorphic and hyperchromatic spindle‐shaped cells arranged in an interdigitating fascicle. The nuclei were of moderate to severe atypia. An average of 10 mitoses per 10 high‐power fields was seen. Immunohistochemically, the stromal cells were positive for vimentin and α‐smooth muscle actin, but negative for S‐100 protein, cytokeratin and desmin. The average Ki‐67 (MIB1) labeling index in the stromal cells was 34%. Electron microscopic evaluation revealed further evidence of smooth muscle differentiation; stromal cells had frequently indented nuclei, well‐developed rough endoplasmic reticulum, thin basal lamina and dense patch‐like structures within the cytoplasm. Analysis of previous literature on 17 cases reveals mitotic activity of the tumor seemingly of little prognostic value. This case indicated difficulty in diagnosing leiomyosarcoma. The risk of local recurrence remains even if the surgical margin is free of tumor cells.