engleski

Mammary myofibroblastoma of the accessory breast tissue

Background Mammary myofibroblastoma is a very rare benign tumor of stromal breast fibro-myofibroblasts with extremely diverse morfological features, including epitheloid, cellular, deciduoid- like, infiltrative, lipomatous, mixoid, collagenized and mixed variant. According to A. Kajava (1915) accessory breast tissue is classified in to eight classes depending on the clinical and histopathological finding of nipple , areola and glandular parenchyma of the breast. Case report A 71 year-old women presented with supernumerary breast tissue in the rear left axillary fold, with clinically well developed nipple and areola, which was, according to history of patients, slowly increasing since puberty, with the acceleration of growth in the last year. Physical examination found dense node 4 cm in diameter. Ultrasound has described a well-defined formation that has been punctured. Fine needle aspiration cytology showed moderate cellularity, mostly single atypical cells, eccentrically placed oval nuclei with coarse chromatin and inconspicuous nucleoli, medium abundant basophilic cytoplasm. This cytological appearance led to diagnosis of adenocarcinoma. Macroscopic examination o f cross section of the material determined well -defined, swirling and gray colored node. Histologically, the tumor was composed of bundles of tumor cells predominantly epitheloid appearance, which were separated by a thick bands of collagen. Immunohistochemical profile of tumor cells was: vimentin +, CD10 +, calponin +, AE1 / AE3-, and led to final diagnosis of mammary myofibroblastoma. Microscopically, the nipple was made of skin like tissue with subcutaneous fat, which was prevalent in the remaining brea st tissue, while collecting ducts nor acini were not found. Described clinico-pathological changes in the supernumerary breast correspond to class V of A. Kajava classification, called pseudomamma. Conclusion Cytological specimen and small biopsy sample e valuation of myofibroblast tumor is always very challenging due to the high diversity of its growth pattern. The main diagnostic problems are malignant epithelial tumors of the breast and the other types of spindle cells tumors of the breast, phyllodes tumor as well as hemangiopericytoma. On the opposite side, very frequent finding of supernumerary breast tissue becomes clinically interesting only when it is joined with other conditions and diseases of the breast.

Mammary myofibroblastoma; Accessory breast tissue

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