Male breast cellular myofibroblastoma with a rich reticulinic network: case report

An Immunohistochemical Anomaly: A Case Report and Systematic Review of Myofibroblastoma of the Breast

Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are treated by surgical excision. The diagnosis of MFB is made through immunohistochemical (IHC) analysis, with the most common biomarkers being CD34+, desmin+, smooth muscle actin+, and vimentin+. In this article, we describe a case of an MFB in a premenopausal female with variance from classic IHC findings. We also performed a systemic review of the MFB of the breast. The systemic review compiles the most common IHC findings of MFB, patient demographics, treatment methods, lesion size, and the presence or absence of pain associated with the lesion. As MFB can share many features with other breast lesions, including potentially malignant ones, this article sought to underline the most common IHC findings and characteristics of MFB to aid in the proper diagnosis of MFB.

A case of adenomyoepithelioma with myoepithelial carcinoma of the breast

Adenomyoepithelioma with myoepithelial carcinoma of the breast is rare and diagnosed with histology and immunohistochemistry. We present a case of malignant transformation over 10 years, with ultrasonographic findings, highlighting the importance of an early excisional biopsy. Conservative surgery and radiation therapy were performed. There was no recurrence for 2 years.

Inflammatory myofibroblastic tumor of the lumbar spinal canal: A Case Report With Literature Review

RATIONALE

Inflammatory myofibroblastic tumor (IMT) is a rare type of mesenchymal tumor. IMT can arise in multiple anatomic locations. IMT of the lumbar spinal canal is exceptionally rare.

PATIENT CONCERNS

Here, we report the case of a 56-year-old male patient with an IMT who was in good health until 1 year prior to admission, when he began experiencing pain in both lower extremities and the lower back.

INTERVENTIONS

A space-occupying lesion in the lumbar canal was identified by magnetic resonance imaging and then surgically resected.

DIAGNOSES

Histopathological analysis of the lesion revealed a composition of mucous edema, inflammatory cells, collagenous fibers, and spindle cells that were diffuse and positive for smooth muscle actin and CD68; focal positive for vimentin and desmin; and negative for CD34 (marker of vascular endothelial cells), CD21, CD23, CD35, S-100, Epstein-Barr virus infection, Ki-67, and anaplastic lymphoma kinase. Thus, the diagnosis was an IMT of the lumbar canal.

OUTCOMES

In the spinal canal, IMT should be considered in the evaluation of tumors although it is a very rare diagnosis. It is a benign lesion, but it has potential for invasion and recurrence.

LESSONS

There are no characteristic imaging features of these tumors, but they can be addressed by complete surgical excision. Patients with these lesions should undergo frequent long-term follow-up to detect and address recurrence.

C-Kit, CD34 & α-SMA Immunohistochemical Features in Classic Kaposi Sarcoma and Kaposiform Hemangioendothelioma

Purpose & Methods:

The aim of this work was to study the clinicopathological features of Kaposi sarcoma (KS) & kaposiform hemangioendothelioma (KHE) and analyze their immunohistochemical expression of c-Kit, CD34, α-SMA. The study was performed on cutaneous 10 classic KS & 8 KHE.

Results:

KHE shows several dilated lymphatic channels, focal capillary formation, lack of nuclear atypia and mitosis within tumor cells. These features help to exclude Kaposi sarcoma in spite of the kaposiform pattern of tumor cells. C-Kit was expressed by tumor cells in all KHE cases and in 60% only of KS. All elements within both tumor groups expressed CD34 antibody. α-SMA was expressed by tumor cells in 70% of KS cases and none of KHE.

Conclusion:

C-Kit and CD34 seem to be reliable at labeling KS and KHE as they can help in diagnosis of these tumors in routinely processed tissue but they don’t differentiate between them. If α-SMA also labeled the tumor, then KHE diagnosis can be ruled out. KS & KHE exemplify stem cell tumors that could give smooth muscle cell–like phenotype in KS. Anti C-kit therapy should be tested in KS & KHE to prevent recurrence.

Mesenchymal-to-endothelial transition in Kaposi sarcoma: a histogenetic hypothesis based on a case series and literature review

OBJECTIVES

Although several studies have been conducted regarding Kaposi sarcoma (KS), its histogenesis still remains to be elucidated. The aim of our study was to analyze the immunophenotype of Kaposi sarcoma and to present a hypothesis about the histogenesis of this tumor, based on a case series and a review of relevant literature.

METHODS

In 15 cases of KSs diagnosed during 2000-2011, the clinicopathological features were correlated with the immunoexpression of c-Kit, SMA, CD34, CD31, vascular endothelial growth factor (VEGF), COX-2, c-KIT, smooth muscle antigen (SMA), and stem cell surface marker CD105.

RESULTS

Both CD105 and c-KIT rate of the spindle-shaped tumor cell positivity increased in parallel to the pathological stage. All cases displayed CD105 and weak c-KIT positivity in the endothelial cells. SMA, VEGF, and COX-2 were focally expressed in all cases. CD34 marked both endothelium and spindle-shaped tumor cells. No c-KIT expression was noticed in KS of the internal organs.

CONCLUSIONS

KS seems to be a variant of myofibroblastic tumors that originates from the viral modified pluripotent mesenchymal cells of the connective tissue transformed in spindle-shaped KS cells, followed by a mesenchymal-endothelial transition and a myofibroblastic-like differentiation. This paper mailnly showed that KS cannot be considered a pure vascular tumor.