1/20. Unilateral virginal breast hypertrophy.A case of unilateral virginal breast hypertrophy with a review of the etiological factors and treatment modalities is presented. A 16-year-old girl presented with progressive enlargement of the left breast of 5 months' duration. The result of the mammographic examination was consistent with cystosarcoma phyllodes. Fine-needle aspiration biopsy revealed giant fibroadenoma. Although some of the characteristics of the fine-needle aspiration biopsy specimen were suspicious for cystosarcoma phyllodes, there were no adequate epithelial structures, which are obligatory for the diagnosis. The patient was treated with subcutaneous mastectomy and subpectoral insertion of a silicone gel implant. The histopathological examination was consistent with virginal hypertrophy. The breast maintained its volume with no further growth in the affected or in the normal breast after 4 years of follow-up.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/20. Fine needle aspiration cytology of fibroadenoma with multinucleated stromal giant cells. A review of cases in a six-year period.OBJECTIVE: To describe the fine needle aspiration cytology findings of fibroadenoma with multinucleated stromal giant cells, with histologic correlation. STUDY DESIGN: The author reviewed the cytologic findings of two cases of fibroadenoma with multinucleated stromal giant cells from the file of Pamela Youde Nethersole Eastern Hospital in a six-year period from 1995 to the end of 2000. The diagnosis was confirmed by histologic examination of the lumpectomy specimens. RESULTS: The two cases had similar cytologic findings. The direct smears contained cohesive clusters of bland-looking ductal cells arranged in a "staghorn" pattern. Numerous naked nuclei were also seen in the background. Also, there were occasional multinucleated giant cells in isolation. These giant cells contained 5-10 randomly arranged, round to oval nuclei, fine chromatin and sometimes distinct nucleoli. The cytoplasm was abundant and pale staining, and the cell border was ill defined. Associated epithelioid histiocytes and foamy macrophages were not seen. Histologic examination of the lumpectomy specimens showed architectural features of fibroadenoma with pericanalicular and intracanalicular patterns. In addition, scattered multinucleated giant cells with focal degenerative change were noted in the tumor stroma. Their stromal nature was confirmed by immunohistochemical study. CONCLUSION: Multinucleated stromal giant cells are rarely identified in fine needle aspiration biopsies of fibroadenoma. Recognition of this peculiar finding may help to avoid misdiagnosis of other, more sinister conditions, such as phyllodes tumor and metaplastic carcinoma.- - - - - - - - - - ranking = 10keywords = giant (Clic here for more details about this article) |
3/20. Fine needle aspiration cytologic features of mammary phyllodes tumors.OBJECTIVE: To evaluate specific diagnostic fine needle aspiration cytologic (FNAC) features of phyllodes tumor (PT), particularly in the differentiation from fibroadenoma (FA). STUDY DESIGN: Twenty-eight FNAC of PT were reviewed for smear cellularity, epithelial and stromal fragments, their size and atypia, epithelial/stromal area ratio, background single stromal cells (oval or columnar), multinucleated giant cells, and squamous and apocrine cells. Twenty-one FNAC of fibroadenoma were also assessed for comparison. RESULTS: PT was significantly larger than FA. Epithelial fragments were found in all cases, with atypia present in PT. Stromal fragments were present in half the cases; there was no difference in stromal size, but the epithelial/stromal area ratio was significantly lower in PT than FA. Single columnar stromal cells with recognizable cytoplasm and multinucleated stromal giant cells were seen in some PT but not in FA. CONCLUSION: Cytologic diagnosis of PT remains difficult, with significant overlap with FA. The presence of large size, low epithelial/stromal ratio, epithelial atypia, columnar stromal cells with visible cytoplasm and stromal giant cells favors a diagnosis of PT over FA.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
4/20. Aggressive giant fibroepithelial lesion with unusual vascular stroma--a case report.The stroma of fibroadenoma and phyllodes tumor usually consists of fibroblastic proliferation. Rarely the stroma contains bundles of smooth muscle. Pseudoangiomatous hyperplasia of the mammary stroma has been described in fibroadenomas. However, true benign vascular stroma has not been reported. We report a case of a 34-year-old Chinese woman who presented with a large mass occupying the entire left breast. Left mastectomy was performed and showed a large, well-circumscribed, lobulated, rubbery-firm tumor measuring 13 x 10 x 6 cm. Microscopic examination revealed a fibroepithelial tumor formed by an organoid pattern of ductal structures with a very striking stromal appearance composed of extensive vascular proliferation and that demonstrated strong immunoreactivity for CD31, CD34, and factor viii. Ultrastructural examination revealed intercellular junctions, basal lamina, pinocytotic vesicles, and weibel-palade bodies in the cells lining the vascular spaces, confirming their endothelial nature. These findings rule out the diagnosis of pseudoangiomatous hyperplasia. The patient developed local recurrence a year later, and the resection showed malignant phyllodes tumor with ductal carcinoma in situ.The extensive vascular stroma noted in the primary tumor may have played a role in the malignant transformation of the epithelial and stromal components in this tumor.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
5/20. Giant metastatic cystosarcoma phyllodes to the lung: CT and MR findings.The authors present a case of giant pulmonary metastasis from cystosarcoma phyllodes of the breast, and correlate the CT and MR findings with the pathological findings. Although CT showed homogenous low density in most parts of the tumor, T 2-weighted MR images presented a more variegated appearance, namely, peculiar slit-like areas of low intensity between areas of high intensity. The MR findings reflected the characteristic gross pathology of cystosarcoma phyllodes, showing narrow cavities filled with bloody fluid surrounding intracystic protruding tumors with abundant necrotic change.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/20. Cystosarcoma phyllodes: report of two cases.Cystosarcoma phyllodes is a rare predominantly benign tumour usually affecting the female breast. In a retrospective review of giant breast masses seen over a period of 20 years, we encountered two cases of this tumour, one benign and the other malignant, the latter exhibiting the very unusual feature of axially lymph node metastases. We present these two cases and briefly review the literature.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/20. Malignant phyllodes tumor of the prostate.This is a report of a 70-year-old man with malignant phyllodes tumor of prostate. The retropubic prostatectomy was done. The stroma of the tumor was cellular and composed of elongated cells with spindle shaped nuclei and fragmented bizarre giant cells. After recovery from surgery, prophylatic radiotherapy was given over 2 months. A case report of a patient treated at our medical center and a review of the literature was done.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/20. leiomyosarcoma of the breast: report of a case with fine needle aspiration cytologic, histologic and immunohistochemical features.BACKGROUND: leiomyosarcoma of the breast is a rare neoplasm. We present a case of primary leiomyosarcoma of the breast in a middle-aged female in whom fine needle aspiration cytologic features suggested sarcoma. CASE: A 55-year-old female presented with a rapidly growing breast lump of 1 month's duration. On examination, an ulcerating, 12 x 10 cm tumor was seen involving the lower medial and lateral quadrants of the right breast. Fine needle aspiration cytology showed variably sized, dissociated and loosely clustered polygonal, plump and spindle cells with pale blue cytoplasm and vesicular nuclei that were round, oval or irregular. Occasional giant forms and nucleolated and mitotic cells were present. A single cluster of benign ductal cells was seen. The tumor cells did not express immunocytologic reactivity to estrogen receptor protein. A cytologic diagnosis of sarcoma was given with differential diagnoses of metaplastic carcinoma and malignant phyllodes tumor. Histologic study established the diagnosis of leiomyosarcoma. leiomyosarcoma of the breast shows fine needle aspiration cytologic features of sarcoma, but specific tumor typing may not be possible, especially when the cytologic material is inadequate for ancillary staining required to distinguish leiomyosarcoma from metaplastic carcinoma and malignant phyllodes tumor.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/20. Multiple, giant fibroadenoma.Multiple, giant fibroadenomas are histologic and clinical variants of "juvenile" or "giant" fibroadenomas. These tumors are rare and occur mainly in adolescent and young adult black females. The individual lesions are well encapsulated with a histologic pattern primarily of the "juvenile" type, although cases of the "adult" type have been reported. A high incidence of recurrence is noted upon local excision, although this may decrease as the patient becomes older. Management options include local excision with reconstruction, reduction mammoplasty, and simple mastectomy with reconstruction. A case is described of this condition with review of the literature.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
10/20. Gigantic cystosarcoma phyllodes in a man with gynecomastia.A 70-year-old man had a breast tumor for 50 years. The tumor, which weighed 8.6 kg, proved to be a malignant cystosarcoma phyllodes. It was successfully removed by a simple mastectomy with low axillary dissection, and a skin graft was performed. The lesion was associated with gynecomastia, and it is believed to have represented a cystosarcomatous transformation of a giant fibroadenoma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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