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Benign soft-tissue myoepithelioma of the tip of the toe: a case report and literature review. CURRENT ORTHOPAEDIC PRACTICE 2020. [DOI: 10.1097/bco.0000000000000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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2
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Accurso A, Donofrio V, Insabato L, Mosella G. Adenomyoepithelioma of the Breast. A Case Report. TUMORI JOURNAL 2018; 76:606-10. [PMID: 2178287 DOI: 10.1177/030089169007600621] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adenomyoepithelioma is a proliferative disorder of both epithelial and myoepithelial cells. This lesion may be found in salivary glands, skin appendages and, very rarely, in the mammary gland. Adenomyoepithelioma was first described in 1970 and very few cases have so far been reviewed in the literature. This paper reports the clinical, histological and immunohistochemical characteristics of an adenomyoepithelioma in a 24 year old woman; to our knowledge this is the first published case in such a young patient. The clinical feature suggested a fibroadenoma. A more complete study of the excised tumor tissue by immunohistochemical and ultrastructural analysis proved that the correct diagnosis was adenomyoepithelioma. Whether adenomyoepithelioma is a benign or a low-grade malignant lesion is still controversial and, therefore, the therapeutic approach is not well defined.
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Affiliation(s)
- A Accurso
- Seconda Facoltà di Medicina e Chirurgia, VI Divisione di Chirurgia Generale, Università degli Studi di Napoli, Italy
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3
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Foschini MP, Morandi L, Asioli S, Giove G, Corradini AG, Eusebi V. The morphological spectrum of salivary gland type tumours of the breast. Pathology 2017; 49:215-227. [DOI: 10.1016/j.pathol.2016.10.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/23/2016] [Accepted: 10/30/2016] [Indexed: 12/16/2022]
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4
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Hayes MM. Adenomyoepithelioma of the breast: a review stressing its propensity for malignant transformation. J Clin Pathol 2011; 64:477-84. [DOI: 10.1136/jcp.2010.087718] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This review describes the classification, clinical presentation, pathological features and clinical behaviour of adenomyoepithelioma (AME) of the breast. It is based on an extensive review of the literature and study of a collection of cases built up over a 17-year period at the British Columbia Cancer Agency. The diversity of the morphology encountered in both benign and malignant AME is described. The behaviour of malignant AME seems to be related to the grade of the malignant component.
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5
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Foschini MP, Krausz T. Salivary gland-type tumors of the breast: a spectrum of benign and malignant tumors including "triple negative carcinomas" of low malignant potential. Semin Diagn Pathol 2010; 27:77-90. [PMID: 20306833 DOI: 10.1053/j.semdp.2009.12.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Salivary gland-type neoplasms of the breast are uncommon and comprise numerous entities analogous to that more commonly seen in salivary glands. The clinicopathologic spectrum ranges from benign to malignant but there are important differences as compared with those of their salivary counterpart. In the breast, benign adenomyoepithelioma is recognized in addition to malignant one, whereas in the salivary gland a histologically similar tumor is designated as epithelial-myoepithelial carcinoma without a separate benign subgroup. Mammary adenoid cystic carcinoma is a low-grade neoplasm compared with its salivary equivalent. It is also important to appreciate that in contrast to "triple negative" conventional breast carcinomas with aggressive course, most salivary-type malignant breast neoplasms behave in a low-grade manner. Most of these tumors are capable of differentiating along both epithelial and myoepithelial lines, but the amount of each lineage-component varies from case to case, contributing to diagnostic difficulties. Well established examples of this group include pleomorphic adenoma, adenomyoepithelioma, and adenoid cystic carcinoma. Another family of salivary gland-type mammary epithelial neoplasms is devoid of myoepithelial cells. Key examples include mucoepidermoid carcinoma and acinic cell carcinoma. The number of cases of salivary gland-type mammary neoplasms in the published data is constantly increasing but some of the rarest subtypes like polymorphous low-grade adenocarcinoma and oncocytic carcinoma are "struggling" to become clinically relevant entities in line with those occurring more frequently in salivary glands.
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Affiliation(s)
- Maria P Foschini
- Department of Hematology and Oncology, Section of Anatomic Pathology at Bellaria Hospital, L. and A. Seragnoli University of Bologna, Bologna, Italy.
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6
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Hikino H, Nagaoka S, Miura H, Kurosumi M. Benign myoepithelioma of the breast: Origin and development. Pathol Int 2009; 59:422-6. [DOI: 10.1111/j.1440-1827.2009.02388.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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7
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Otterbach F, Schmid KW. [Salivary gland-like tumors of the breast]. DER PATHOLOGE 2006; 27:363-72. [PMID: 16896677 DOI: 10.1007/s00292-006-0851-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A subset of rare benign and malignant breast tumors with and without myoepithelial differentiation are morphologically and histogenetically similar to salivary gland tumors, but may differ in incidence and clinical behavior. The clinicopathological, immunohistochemical, molecular and prognostic features of ten salivary gland-like tumor entities of the breast are discussed and compared with their respective counterparts in the salivary glands.
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Affiliation(s)
- F Otterbach
- Institut für Pathologie und Neuropathologie, Universitätsklinikum, Hufelandstrasse 55, 45122, Essen, Germany.
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8
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Kdous M, Hachicha R, Gamoudi A, Rahal K. [Breast myoepithelioma. Diagnostic and therapeutic difficulties. A case report]. ACTA ACUST UNITED AC 2004; 32:42-5. [PMID: 14736599 DOI: 10.1016/j.gyobfe.2003.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Breast myoepithelioma is rare. The case of a 61-year-old female is reported here. The tumor was clinically, radiologically and macroscopically demarcated. Diagnosis was based on histological and immunohistochemical studies. At the time of diagnosis the tumor consisted of myoepithelial cells with few cellular atypias and a low mitotic activity. Tumor cells expressed vimentin, actin, S100 protein and cytokeratin. No local or distant metastases were found. The patient had been treated initially with a large excision of tumor. Local recurrences detected one year after initial surgery and showed a similar morphology and immunoreactivity with higher mitotic activity. Mastectomy with axillary dissection was performed. Neither recurrences nor distant metastases detected two years later. Myoepithelial tumors which are generally considered as benign or low-grade lesions can give rise to a wide range of clinical evolution.
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Affiliation(s)
- M Kdous
- Service de chirurgie carcinologique, institut Salah-Azaiez de Tunis, boulevard du 9-Avril, 1006 Tunis, Tunisie.
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9
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Yang X, Hori T, Fukuda A, Kamimura Y, Hirakawa K, Maeda H, Miyajima H. Malignant myoepithelioma with a squamous epithelial component in the mammary gland of a cynomolgus monkey. Toxicol Pathol 2003; 31:549-53. [PMID: 14692623 DOI: 10.1080/01926230390226672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A solid mass arising from the mammary gland was found in a 7-year-old female cynomolgus monkey. Histologically, the mass consisted of 2 components: spindle-shaped or ovoid sarcomatous cells and squamous epithelial cells. Metastatic nodules noted in the lung, liver and the gallbladder had the same histological features as the mammary mass. Immunohistochemistry revealed that the sarcomatous cells were positive for alpha-smooth muscle actin (alpha-SMA), vimentin, calponin, S-100 protein, epithelial membranous antigen (EMA), cytokeratin (large spectrum) and cytokeratin 14 (CK 14) in the cytoplasm, and p53, erbB-2 and progesterone receptor in the nuclei, but negative for desmin and estrogen receptor. The squamous epithelial cells were positive for EMA, cytokeratin (large spectrum) and CK 14, but negative for the rest. Both sarcomatous and squamous epithelial components were negative for glial fibrillary acidic protein (GFAP). Based on histological and immunohistochemical features, the present case was diagnosed as a malignant myoepithelioma with a squamous epithelial component in the mammary gland with distant metastases.
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Affiliation(s)
- Xiuying Yang
- Drug Safety Research Laboratories, Shin Nippon Biomedical Laboratories, Ltd, 2438 Miyanoura, Yoshida, Kagoshima 891-1394, Japan.
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10
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Pia-Foschini M, Reis-Filho JS, Eusebi V, Lakhani SR. Salivary gland-like tumours of the breast: surgical and molecular pathology. J Clin Pathol 2003; 56:497-506. [PMID: 12835294 PMCID: PMC1769991 DOI: 10.1136/jcp.56.7.497] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2003] [Indexed: 01/18/2023]
Abstract
Breast glands and salivary glands are tubulo-acinar exocrine glands that can manifest as tumours with similar morphological features, but that differ in incidence and clinical behaviour depending on whether they are primary in breast or salivary glands. Salivary gland-like tumours of the breast are of two types: tumours with myoepithelial differentiation and those devoid of myoepithelial differentiation. The first and more numerous group comprises a spectrum of lesions ranging from "bona fide" benign (such as benign myoepithelioma and pleomorphic adenoma), to low grade malignant (such as adenoid cystic carcinoma, low grade adenosquamous carcinoma, and adenomyoepithelioma), to high grade malignant lesions (malignant myoepithelioma). The second group comprises lesions that have only recently been recognised, such as acinic cell carcinoma, oncocytic carcinoma of the breast, and the rare mucoepidermoid carcinoma.
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Affiliation(s)
- M Pia-Foschini
- Department of Pathology, University of Bologna, at Ospedale Bellaria, Bologna, I-40139 Italy
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11
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Venkatraman L, Sinnathuray AR, Raut V, Brooker DS, McCluggage WG. Soft tissue myoepithelioma: a case report. Pathology 2002; 34:451-4. [PMID: 12408345 DOI: 10.1080/0031302021000009388] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Myoepitheliomas are tumours composed predominantly or exclusively of myoepithelial cells. They are well described, especially within the salivary gland, but their occurrence in soft tissues is less well known and this often results in diagnostic problems. We report a case involving the deep soft tissues of the lower neck behind the clavicle. Grossly, the tumour was well circumscribed with solid and cystic areas. Histology showed a richly vascularised tumour composed of bland round, ovoid or spindle-shaped cells. Various growth patterns were present including solid, nested, microcystic and trabecular arrangements. In some areas there was an alveolar pattern with tumour cells lining fibrous septae. Immunohistochemistry showed diffuse strong positivity for S100 protein, calponin, vimentin and glial fibrillary acidic protein and focal positivity for epithelial membrane antigen, 34betaE12 and AE1/AE3, in keeping with myoepithelial differentiation. Electron microscopy revealed tumour cells surrounded by basal lamina with subplasmalemmal densities and containing cytoplasmic myofilaments. This case report highlights the rare occurrence of myoepitheliomas in deep soft tissues. Pathologists should be aware of this and should consider a myoepithelioma in the differential diagnosis of a soft tissue spindle cell neoplasm.
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Affiliation(s)
- L Venkatraman
- Department of Pathology, Royal Group of Hospitals Trust, Belfast, Northern Ireland
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12
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Jolicoeur F, Seemayer TA, Gabbiani G, Robidoux A, Gaboury L, Oligny LL, Schürch W. Multifocal, nascent, and invasive myoepithelial carcinoma (malignant myoepithelioma) of the breast: an immunohistochemical and ultrastructural study. Int J Surg Pathol 2002; 10:281-91. [PMID: 12490978 DOI: 10.1177/106689690201000406] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This report describes the light microscopic (LM), immunohistochemical (IHC), and electron microscopic (EM) features of a multifocal, nascent, and invasive myoepithelial carcinoma of the breast. By LM, the spindle cells disclosed fibrillar acidophilic cytoplasm, mild nuclear atypia, and a low mitotic index. Myoepithelial differentiation was established through IHC (single- and double-labeling techniques) and EM: periductal and infiltrating spindle cells coexpressed total muscle actin, alpha-smooth muscle actin, vimentin, cytokeratin 14, and pankeratin, and their EM features were characteristic of myoepithelial cells, i.e., perinuclear tonofilaments, subplasmalemmal bundles of microfilaments with dense bodies, intermediate junctions, poorly developed desmosomes, pinocytic vesicles, and fragmented external lamina. No invasive epithelial cells disclosed luminal differentiation (by LM, IHC, EM), identifying, thus, this neoplasm as a pure spindle cell myoepithelial carcinoma of the breast.
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13
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Abstract
Spindle cell tumours of the breast are uncommon and often present diagnostic challenges. The most important is the sarcomatoid/metaplastic carcinoma, which has monophasic and biphasic variants. Each of these groups presents special diagnostic difficulties. In the monophasic variant the mesenchymal component predominates and the epithelial element forms a minor component often detected only after immunohistochemical study. The spindle cell areas may be bland and therefore under-diagnosed as nodular fasciitis or fibromatosis. Alternatively they may be highly malignant with a pattern that is misinterpreted as primary sarcoma of the breast. In the biphasic variant, the difficulty is in distinguishing between sarcomatoid carcinoma, myoepithelial carcinoma or malignant phyllodes tumour. Other spindle cell lesions of the breast include the various myofibroblastic tumours, the spindle cell variant of adenomyoepithelioma, the varied primary breast sarcomas, metastatic tumours with spindle cell morphology and, finally, the very rare follicular dendritic cell tumour. A simple practical approach to the diagnosis of spindle cell lesions is presented to help the general surgical pathologist to compile a differential diagnosis and to arrive at the correct conclusion
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Affiliation(s)
- A Al-Nafussi
- Department of Pathology, University of Edinburgh, Edinburgh, UK. aan@srv4/med.ed.ac.uk
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14
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15
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Merson M, Di Palma S, Feudale E, Luini A. Myoepithelioma of the breast. Breast 1995. [DOI: 10.1016/0960-9776(95)90014-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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16
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Abstract
A tumor of the right breast was noticed in a 70 year old female. The tumor was round, 1 x 1 cm, and was encapsulated with thin fibrous tissue. The boundary was clear. The cut surface showed a mosaic pattern of brown and white dots and the texture was gritty. Histologically, glandular structures, trabecular or solid epithelial cell nests, myxoid, cartilaginous and osteoid areas, and one ossifying focus were found. Round, polyhedral or fusiform myoepithelial cells proliferated around the glandular structures and were dispersing into the myxoid and cartilaginous tissue. Myoepithelial proliferation was especially marked around the small glandular structure. Immunohistochemically, S-100 protein was strongly positive for the myoepithelial cells around the glandular structures and in the cartilaginous tissue. Until now, 54 cases of pleomorphic adenoma of the breast have been reported. In those cases, the subareolar region was a common site for the tumor, and pleomorphic adenoma was thought to arise from large ducts in this region. No Oriental patients have been reported in the literature.
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Affiliation(s)
- T Narita
- Department of Pathology, Mutsu General Hospital, Japan
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17
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Niemann TH, Benda JA, Cohen MB. Adenomyoepithelioma of the breast: fine-needle aspiration biopsy and histologic findings. Diagn Cytopathol 1995; 12:245-50. [PMID: 7621720 DOI: 10.1002/dc.2840120311] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Adenomyoepithelioma is an uncommon tumor of the breast which clinically presents as a discrete nodule and histologically is composed of lumenal spaces lined by a mixture of epithelial and myoepithelial cells. It has a spectrum of histologic appearances which are gradually gaining wider recognition. There are, however, only a few descriptions of the fine-needle aspiration biopsy (FNAB) findings in adenomyoepithelioma. We report the FNAB and histologic features of a mammary adenomyoepithelioma which contained a prominent epithelial component including a focus of marked epithelial atypia. This expands the spectrum of FNAB findings which have been reported in adenomyoepithelioma.
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Affiliation(s)
- T H Niemann
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52242-1009, USA
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18
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Abstract
Adenomyoepithelioma (myoepithelioma) of the breast in a 47-year-old man is reported. The tumor consisted of a prominent proliferation of spindle cells surrounding mammary ducts. Immunohistochemical and electron microscopic observations confirmed the myoepithelial origin of these spindle cells. This is the first report of an adenomyoepithelioma of the breast that developed in a male.
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Affiliation(s)
- G Tamura
- Department of Pathology, Iwate Medical University School of Medicine, Morioka, Japan
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19
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Vielh P, Thiery JP, Validire P, Annick de Maublanc M, Woto G. Adenomyoepithelioma of the breast: fine-needle sampling with histologic, immunohistologic, and electron microscopic analysis. Diagn Cytopathol 1993; 9:188-93. [PMID: 8390345 DOI: 10.1002/dc.2840090216] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Fine-needle sampling was performed in a woman with a subareolar breast mass. The cytologic diagnosis was consistent with a benign sweat gland-type tumor. Cytologic features included epithelial cells and spindle-shaped cells lying free or in fibrillary myxoid ground substance. Histologic study revealed the biphasic appearance of this tumor composed of proliferating myoepithelial cells and glandular epithelial cells as supported by immunohistologic and electron microscopic analyses. Epithelial cells were strongly positive for cytokeratins, and spindle cells were positive for actin, S-100 protein, and keratin and showed ultrastructurally typical features of myoepithelial cells.
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Affiliation(s)
- P Vielh
- Laboratoire de Cytopathologie Clinique, Institut Curie, Paris, France
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20
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Di Palma S, Pilotti S, Rilke F. Malignant myo-epithelioma of the parotid gland arising in a pleomorphic adenoma. Histopathology 1991; 19:273-5. [PMID: 1655615 DOI: 10.1111/j.1365-2559.1991.tb00034.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- S Di Palma
- Division of Anatomic Pathology and Cytology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy
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21
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Enghardt MH, Hale JH. An epithelial and spindle cell breast tumour of myoepithelial origin. An immunohistochemical and ultrastructural study. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1989; 416:177-84. [PMID: 2480684 DOI: 10.1007/bf01606324] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
An infiltrating epithelial and spindle cell neoplasm developed in the breast of a 63-year-old female. An excisional biopsy was performed. Recurrence with rapid growth due to cyst development eventually resulted in more radical surgery. Interim fine needle aspirations had established its partially cystic nature. The unique microscopic appearance prompted the application of immunohistochemistry and electron microscopy. The tumour cells were found to exhibit characteristics denoting squamous and myoepithelial differentiation. Histopathological features of malignancy were absent. Our findings demonstrate the differentiation potential of breast epithelium. They are in concordance with the results of previous studies which delineate the histochemical and ultrastructural features of myoepithelial and establish the relationship of these cells to squamous metaplasia.
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Affiliation(s)
- M H Enghardt
- Department of Pathology, United States Naval Hospital, Newport, Rhode Island
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22
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Abstract
Two patients developed nodular, well-circumscribed tumors of the breast, discovered by mammography. They were fibroadenoma-like by gross examination and biphasic by light microscopy, containing both tubular glands and spindled myoid cells. Immunocytochemical studies revealed cytokeratin and S-100 immunoreactivity in both the spindled myoid cells and in the tubuloglandular cells (S-100 was focal in the latter). In addition, the spindled myoid cells were immunoreactive for vimentin but negative for desmin. Ultrastructural studies showed the tubular glands to be composed of luminal epithelial cells focally surrounded by myoepithelial cells, but the stroma contained spindled myoepithelial cells admixed with occasional fibroblasts. The diagnostic term, "adenomyoepithelioma," is appropriate for biphasic tumors having both glandular and myoepitheliomatous differentiation. Although additional experience is necessary to be conclusive regarding the biologic behavior of these unusual lesions, the authors believe the adenomyoepitheliomas described here are benign. They were well circumscribed without invasion of adjacent breast, contained neither mitotic figures nor cytologic atypia, and have not recurred or metastasized (6 and 10 months after removal).
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Affiliation(s)
- N Weidner
- Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115
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23
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Abstract
Primary clear cell tumors of the breast are rare neoplasms. Traditionally, their differential diagnosis has included lipid-rich, glycogen-rich, and secretory carcinomas of the breast. Although clear cell myoepithelial tumors of the salivary gland and skin have been reported, a primary clear cell myoepithelial carcinoma of the breast has not been previously described. We report a case of clear cell myoepithelial neoplasm of the breast showing an infiltrative histologic growth pattern highly suggestive of carcinoma. Electron microscopy showed evidence of myoepithelial differentiation manifested by cytoplasmic microfilaments with randomly dispersed fusiform densities in conjunction with specialized membrane junctions and remnants of basal membrane. Immunohistologically, the tumor cells were positive for actin, keratin, and S-100 protein. This tumor should be included in the differential diagnosis of the clear cell neoplasms of the breast.
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Affiliation(s)
- N Cartagena
- Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach
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24
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Tamura S, Enjoji M, Toyoshima S, Terasaka R. ADENOMYOEPITHELIOMA OF THE BREAST. Pathol Int 1988. [DOI: 10.1111/j.1440-1827.1988.tb02338.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Abstract
Adenomyoepithelioma, an uncommon benign breast tumor in which the proliferation of myoepithelial cells is a conspicuous component, was examined in 18 women. The initial clinical finding was usually a mass in the periphery of the breast. Grossly, adenomyoepithelioma produced a circumscribed, firm tumor (average, 1.5 cm) with nodularity and cysts noted in some instances. Proliferating myoepithelial cells and gland-forming epithelial cells were conspicuous in all cases. In most, myoepithelial cells were polygonal and had clear vacuolated cytoplasm. Myoid, spindle-cell differentiation was rarely prominent, but cells of this type were present focally in most cases. Intraductal papillary adenomyoepitheliomatous hyperplasia was present within the tumors and sometimes in surrounding ducts. Immunohistochemical studies distinguished epithelial from myoepithelial cells. Hormone receptor studies showed four tumors were estrogen receptor positive, two were estrogen receptor negative, and five were progesterone receptor negative. One patient who underwent immediate mastectomy is well 4 years later. Two of the 17 women treated by local excision had recurrent adenomyoepithelioma in the same breast. All 18 patients remain well from 0.5 to 5.5 years after diagnosis. No patient had prior, coexistent, or subsequent adenocarcinoma of either breast. These findings indicate that adenomyoepithelioma is a benign tumor that can be adequately treated by complete local excision.
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Affiliation(s)
- P P Rosen
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021
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26
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Abstract
A case of ultrastructurally confirmed myoepithelioma of the breast studied by fine-needle aspiration biopsy is reported. Aspirated tumor cells were spindle-shaped with well-defined cytoplasm and oval nuclei showing no remarkable nuclear pleomorphism. They were seen mainly in irregular bundles with strong cellular cohesiveness. Their cytoplasm contained S-100 protein demonstrated by the peroxidase antiperoxidase staining technique.
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Affiliation(s)
- G K Nguyen
- Department of Pathology, University of Alberta Faculty of Medicine, Canada
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27
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Cuadros CL, Ryan SS, Miller RE. Benign mixed tumor (pleomorphic adenoma) of the breast: ultrastructural study and review of the literature. J Surg Oncol 1987; 36:58-63. [PMID: 3041115 DOI: 10.1002/jso.2930360114] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A patient is presented with a benign mixed tumor (pleomorphic adenoma) of the breast. There are 11 well-documented cases of this rare breast neoplasm. It is histologically and ultrastructurally identical to that seen in the salivary gland and follows a similar benign course. A central role of the ductal myoepithelial cell is proposed for the histogenesis of this tumor.
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28
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Sørensen FB, Paulsen SM. Glycogen-rich clear cell carcinoma of the breast: a solid variant with mucus. A light microscopic, immunohistochemical and ultrastructural study of a case. Histopathology 1987; 11:857-69. [PMID: 3305289 DOI: 10.1111/j.1365-2559.1987.tb01889.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The light microscopic, immunohistochemical and ultrastructural features of a clear cell carcinoma of the breast have been studied. Both intraductal and invasive components were found. Histochemistry showed large amounts of intracytoplasmic glycogen and sparse neutral mucin in the tumour. The tumour cells were stained by antisera to carcinoembryonic antigen, keratin and epithelial membrane antigen, but not by antisera to alpha-lactalbumin, desmin or vimentin. Ultrastructurally, the epithelial derivation of the tumour was confirmed. Only a few intracytoplasmic lumina were demonstrated. The tumour was classified as a mucin-containing variant of glycogen-rich, clear cell carcinoma of the breast.
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29
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Eusebi V, Casadei GP, Bussolati G, Azzopardi JG. Adenomyoepithelioma of the breast with a distinctive type of apocrine adenosis. Histopathology 1987; 11:305-15. [PMID: 2828217 DOI: 10.1111/j.1365-2559.1987.tb02635.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A newly recognized type of dimorphic carcinoma of breast, distinct from adenoid cystic carcinoma, is described. It is characterized by a predominantly solid, clear cell myoepithelial proliferation, with centrally situated glandular lumina lined by apocrine cells. All cases arose in association with a distinctive type of atypical apocrine adenosis which has to be distinguished from microglandular adenosis and from tubular carcinoma. The biological behaviour of the tumour remains to be ascertained on the basis of longer follow-up, but it appears to have only limited malignant potential.
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Affiliation(s)
- V Eusebi
- Istituto di Anatomia e Istologia Patologica, University of Bologna, Italy
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Raubenheimer EJ. The myoepithelial cell: embryology, function, and proliferative aspects. Crit Rev Clin Lab Sci 1987; 25:161-93. [PMID: 3301214 DOI: 10.3109/10408368709105881] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Myoepithelial cells form an integral part of the secretory and ductular portion of most glands. They share a common origin with lumenal epithelial cells and influence proliferation and differentiation of developing terminal glandular buds by producing a scaffold of basement membrane proteins. Their contractile capacity, controlled by hormonal and neural mechanisms, plays an important role in propulsion of secretions. Furthermore, myoepithelial cells maintain glandular structural integrity and transport metabolites to secretory cells. The advent of modern immunochemistry made identification of specific myoepithelial cell markers possible which facilitated studies on their presence and behavior in disease processes. Although the significance of many myoepithelial alterations is speculative, some have proved valuable in determining the histogenesis of glandular lesions.
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Bigotti G, Di Giorgio CG. Myoepithelioma of the breast: histologic, immunologic, and electromicroscopic appearance. J Surg Oncol 1986; 32:58-64. [PMID: 3014226 DOI: 10.1002/jso.2930320116] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This report describes the histologic, immunologic, and ultrastructural features of a distinctive spindle-cell tumor of the female breast interpreted as pure myoepithelioma. By light microscopy, the tumor showed the mammary parenchyma replaced by bundles of fusiform cells, which cytoplasms contained myosin and actin, demonstrated immunologically. Ultrastructurally, the spindle cells were joined by mature desmosomes and presented parallel bundles of microfilaments and remnants of basal lamina.
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Thorner PS, Kahn HJ, Baumal R, Lee K, Moffatt W. Malignant myoepithelioma of the breast. An immunohistochemical study by light and electron microscopy. Cancer 1986; 57:745-50. [PMID: 2417682 DOI: 10.1002/1097-0142(19860215)57:4<745::aid-cncr2820570411>3.0.co;2-8] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Myoepitheliomas of the breast are extremely rare; only four cases have been reported to date. It is not clear whether these tumors behave in a benign or malignant fashion, and no metastatic spread has been documented. We report a myoepithelioma of the breast with metastatic spread to an axillary lymph node. Myoepithelial cell (MEC) differentiation in the tumor was characterized using electron microscopic (EM) criteria. Immunologic investigations at the LM and EM levels showed that the tumor cells were positive for S100 protein, actin, and epidermal cytokeratin; these findings are indicative of MEC differentiation. By immuno-EM, cytokeratin filaments were present in a perinuclear location, while actin filaments were concentrated along the cell periphery. To the authors' knowledge, this is the first report of a breast myoepithelioma that has metastasized and also the first report of the immunologic characterization of a myoepithelioma at the light and electron microscopic levels.
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Abstract
A case of myxoma of the breast is presented. The differential diagnosis with respect to other myxoid tumours of the breast is discussed. Ultrastructurally the tumour cells show features of a primitive mesenchymal cell with possible pericytic or modified myoepithelial cell differentiation. The histogenesis is discussed.
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Rode L, Nesland JM, Johannessen JV. A spindle cell breast lesion in a 54-year-old woman. Ultrastruct Pathol 1986; 10:421-5. [PMID: 2429417 DOI: 10.3109/01913128609007196] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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35
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Abstract
Tumors containing smooth muscle are rare in the breast. A myoepithelial origin for the myoid component of such lesions was postulated in previous reports. Myoepithelial hyperplasia has long been recognized as a common component of some breast lesions, including sclerosing adenosis, papillomas, and fibroadenomas. Three breast tumors composed of variable admixtures of adipose tissue, fibrous tissue, and smooth muscle are described. The authors postulate that the myoid component of two of the three lesions may have arisen in a milieu of myoepithelial hyperplasia. The origin of the myoid component in the third case is not clearly defined.
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Schürch W, Potvin C, Seemayer TA. Malignant myoepithelioma (myoepithelial carcinoma) of the breast: an ultrastructural and immunocytochemical study. Ultrastruct Pathol 1985; 8:1-11. [PMID: 2413600 DOI: 10.3109/01913128509141504] [Citation(s) in RCA: 60] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This report describes the light (LM) and electron microscopic (EM) features and the results of an indirect immunofluorescence study (IF), the latter using monoclonal and monospecific antibodies to cytoskeletal proteins, of a malignant, invasive and metastatic breast myoepithelioma. A 53-year-old female underwent mastectomy for a large necrotic mammary tumor that had invaded the overlying skin. By LM, the neoplasm was composed of interlacing bundles of large, elongated and interspersed stellate cells with acidophilic cytoplasm. The neoplastic cells displayed a moderate degree of anaplasia, high mitotic activity, and strong tendency for necrosis. Stromal desmoplasia was marked, especially toward the center of the neoplasm. By IF, the tumor cells revealed bright cytoplasmic fluorescence with antibodies to actin, prekeratin, and cytokeratin. A few scattered spindle cells, which stained with the anti-vimentin and anti-actin anti-bodies, most likely represented stromal myofibroblasts. The anti-desmin reaction was negative. By EM, the neoplasm was composed of variably differentiated, elongated and stellate myoepithelial cells connected by desmosomes, enveloped by remnants of basal lamina, and containing pinocytotic vesicles, a well-developed rough endoplasmic reticulum, large Golgi areas, aggregates of intermediate filaments that were often arranged in dense curvilinear bundles (tonofilaments), and bundles of microfilaments with fusiform, dense bodies. The combined LM, EM, and IF study of this mammary tumor establishes its myoepithelial origin and, thus, identifies it as myoepithelial carcinoma distinct from other spindle cell breast tumors. This neoplasms was locally invasive and cytologically malignant; moreover, its malignancy was further confirmed by the development of lung and pleural metastases.
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Kiaer H, Nielsen B, Paulsen S, Sørensen IM, Dyreborg U, Blichert-Toft M. Adenomyoepithelial adenosis and low-grade malignant adenomyoepithelioma of the breast. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1984; 405:55-67. [PMID: 6438900 DOI: 10.1007/bf00694925] [Citation(s) in RCA: 64] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Adenomyoepithelial adenosis of the breast is a form of adenosis not previously described. It is similar in several ways to microglandular adenosis, but one significant difference is the presence of myoepithelial cells. The present case originated as adenomyoepithelial adenosis in a 46-year-old woman. In the course of 18 years it proliferated and changed into a low-grade malignant adenomyoepithelioma. Electron microscopy confirmed the presence of myoepithelial cells in the adenosis, and immuno-histochemical study demonstrated cells containing actin (representing myoepithelial cells) in the adenosis as well as in the adenomyoepithelioma.
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Hull MT, Priest JB, Broadie TA, Ransburg RC, McCarthy LJ. Glycogen-rich clear cell carcinoma of the breast: a light and electron microscopic study. Cancer 1981; 48:2003-9. [PMID: 6271388 DOI: 10.1002/1097-0142(19811101)48:9<2003::aid-cncr2820480916>3.0.co;2-q] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A glycogen-rich clear cell carcinoma arose in the breast of a 49-year-old woman. Light microscopic examination of the neoplasm revealed both intraductal papillary growth and stromal invasion. Electron microscopic examination demonstrated neoplastic cells that contained massive quantities of nonmembrane-bound particulate glycogen and that formed numerous acini. Apically, these cells formed microvilli; laterally they formed tight junctions and desmosomes. Morphologic features of this neoplasm are similar to those of the fetal breast and to some other clear cell carcinomas arising elsewhere in the body.
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Tóth J, Sugár J, Csuka O. The role of myoepithelial cells in the morphogenesis of induced mammary tumours. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOLOGY 1979; 385:41-8. [PMID: 162099 DOI: 10.1007/bf00433539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The localization and cytomorphology of myoepithelial (ME) cells and their role in the morphogenesis of the mammary gland tumours of Wistar rats induced by 7,12-Dimethylbenz-a-anthracene-DMBA- were studied. Cells which do not participate in secretion and contain cytoplasmic myofibrillar bundles in a typical arrangement are considered to be of ME origin. In the histogenesis of induced mammary gland tumours no difinite role can be attributed to mature ME cells or their precursors. Decreased differentiation is associated with reduced numbers of ME cells. No ME cells can be detected in the anaplastic, stromafree portions of the solid tumour. The sarcomatous component of the induced carcinosarcomas originates from connective tissue. ME cells may give rise to leiomyoma-like tumours comparable with the human benign mammary myoepithelioma. The atrophic areas of mammary gland tumours consisted mostly of preserved ME cells. The ME cells of induced mammary gland tumours were, in every respect, identical with the normal ME cells of control mammary glands.
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