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Inflammatory myofibroblastic tumor of the breast. A case report.

BACKGROUND: Inflammatory myofibroblastic tumor (IMT) of the breast is a very rare tumor like lesion with only 6 previously reported cases. Very little is known about the cytology of IMT. We present the fine needle aspiration (FNA) cytology of a case of recurrent, bilateral IMT of the breast and detail the clinical course, radiologic findings, morphologic appearances and immunohistochemical profile of the lesion. CASE: A 79-year-old female was initially seen in 1991 because of a suspicious mammographic abnormality in her right breast. Ultrasound-guided FNA cytology showed an unusual "inflammatory" lesion with occasional aggregates of cellular connective tissue fragments, sheets of uniform ductal epithelial cells with myoepithelial cells, spindle cells, lymphocytes and histiocytelike cells. The lesion was excised, and histology confirmed a benign process with spindle cells, lymphocytes and histiocytes. No malignant features were noted. During follow-up many new lesions appeared in both breasts, and after several FNA procedures and local excisions, bilateral mastectomy was performed at the patient's urging. She remained disease free. CONCLUSION: Although IMT of the breast has benign cytology and histology, clinically and on imaging, it resembles carcinoma. Awareness of the condition may help prevent a false diagnosis of carcinoma.

Aged↗

[Chondroid lipoma. Clinicopathological, immunohistochemical, and ultrastructural analysis of six cases of a distinct entity in the spectrum of lipomas].

A series of six cases of chondroid lipoma is reported in this paper. The age of the patients, four women and two men, ranged from 34 to 75 years. Four tumours arose in the lower and two in the upper extremities between 4.5 and 8 cm in size. Whereas two neoplasms were located in the subcutis, four lesions were seen in perifascial or intramuscular tissues. Histologically, all neoplasms were encapsulated and characterized by a somewhat lobular growth pattern. The neoplasms were composed of mature adipocytes, uni - and multivacuolated lipoblasts, and nests and strands of cells reminiscent to hibernoma cells or chondrocytes. Immunohistochemically and ultrastructurally the lipogenic nature of the latter type of cells was confirmed. Interestingly, focal immunopositivity of tumour cells for cytokeratin was found in two cases. Tumour cells were set in a myxohyaline matrix showing different degrees of degeneration. Chondroid lipoma represents a distinct entity in the spectrum of lipomatous lesions and has to be distinguished from benign and malignant neoplasms (extraskeletal chondroma, hibernoma, lipoblastoma, chondrolipoangioma, myoepithelioma, myxoid/round cell liposarcoma, and extraskeletal myxoid chondrosarcoma). Because they are easily misdiagnosed as malignant tumours, familiarity with the features of chondroid lipoma is of practical importance to avoid an overtreatment.

Adipose Tissue↗

Granular cell myoblastoma of the orbit. Report of a case.

A light and electron microscopical study of a case of granular cell myoblastoma of the orbit is described. Its possible histogenesis is discussed and, from the study of this case and of the literature, it is believed that the most likely histogenesis is from a primitive mesenchymal cell resembling a fibroblast.

Histocytochemistry↗

Granular cell tumor (myoblastoma) of the orbit.

A 43-year-old woman had a three-month history of increasing proptosis and visual loss secondary to an inferior orbital mass. Surgical exploration revealed an encapsulated mass that was excised with good visual recovery. Light microscopy as well as electron microscopy confirmed the diagnosis of granular cell myoblastoma. The tumor's location within the orbit was unusual and its histologic origin was uncertain.

Adult↗

Granular cell myoblastoma of the cervical trachea.

Only five granular cell myoblastomas affecting the cervical trachea have been previously reported. Two of these tumors appear to be primary lesions of the trachea, while the remaining three appear to involve it only secondarily. We report a case of an intraluminal granular cell myoblastoma arising from the right tracheal wall in a 45-year-old woman. The tumor extended into the partition wall between trachea and esophagus. Treatment was by surgical excision of the tumor and the involved tracheal ring. The patient was free of recurrence one year after treatment.

Female↗

Selective neck dissections for squamous carcinoma of the upper aerodigestive tract: patterns of regional failure.

BACKGROUND: Surgeons have been using selective neck dissections in the treatment of squamous carcinoma of the upper aerodigestive tract for over 20 years. To date, no data is available that can answer the question "What are the patterns of failure in the neck following a selective neck dissection and is a selective neck dissection a reliable procedure for metastatic disease?" METHODS: To answer this question, the medical records of all patients with squamous carcinoma of the oral cavity, oropharynx, larynx, and hypopharynx treated at The University of Texas M. D. Anderson Cancer Center from January 1, 1985-December 31, 1990, with a selective neck dissection were reviewed. Five hundred seventeen neck dissections were analyzed: suprahyoid (41), supraomohyoid (284), and anterolateral (192). The end point of the study was regional failure and survival. RESULTS: Regional recurrence in patients treated with a suprahyoid dissection was 43% with pathologically positive nodes. The regional recurrence in the patients treated with a supraomohyoid neck dissection was 1.9% with pathologically negative nodes, 35.7% with path N1 without postoperative radiation therapy, and 5.6% with postoperative radiation therapy. The neck staged pathologically N2B failed with and without postoperative radiation, 8.3% and 14%, respectively. Thirteen percent of the anterior/lateral neck dissections failed regionally. If multiple pathologically positive nodes (N2B) were present, the regional failure with postoperative radiation was 30% and 33.3% without postoperative radiation. CONCLUSION: The results of this retrospective study suggest that a selective neck dissection is a satisfactory staging procedure and is a definitive operation if all the nodes are pathologically negative. However, if a node is found to be invaded with cancer, the use of postoperative radiation is advisable.

Carcinoma, Squamous Cell↗