It is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue. An approximately 5-cm mass was palpated in the upper right breast. 'sitekey': sitekey, endobj [16] The authors of a 2012 study have derived a risk calculator for relapse risk of phyllodes tumors after surgery. { Periductal stromal condensation may be seen Frankly sarcomatous stroma may be seen in malignant phyllodes tumor Heterologous differentiation may occur in malignant phyllodes tumor Liposarcoma Osteosarcoma Chondrosarcoma Rhabdomyosarcoma Grading determined by presence or absence of atypical stromal features Kristin C Jensen MD kjensen1@stanford.edu document.getElementById('btnstop_' + ids).style.display = 'none'; Care should be taken when considering the diagnosis of fibroadenoma based only on clinical, radiological, and biopsy findings. Most recent WHO edition (2012) reclassified as "periductal stromal tumour" as the preferred "neutral term" in the family of fibroepithelial tumor Stromal proliferation around open, benign tubules Essential features Considered a type of fibroepithelial tumor lesion with stromal proliferation around benign tubules An extremely rare entity, the PST is actually classified as a subtype of phyllodes tumor, with specific criteria that are only found upon histological examination of the specimen. Am J Surg Pathol 2003; 27: 343-8. A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. Epidemiology Phyllodes tumors account for less than 0.3-1% of all breast neoplasms 13. It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. } Follow-up information, mode of treatment and previous history of. Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma made of spindle cells and lacking phyllodes architecture. It is a challenge to diagnose the phyllodes by conventional trucut biopsy technique. Y?DT6TsMpD,:>/HAa-Mdr(pufrU1jemHr:/ _x]\j*3 function show_hide(flag, ids) Number of Pages:263. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. [Clinicopathologic features and prognostic factors of malignant phyllodes tumors]. Copyright PathologyOutlines.com, Inc. Click, 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA). 3 psts lack the typical leaflike architecture of phyllodes tumors, but display a biphasic morphology with a cellular stroma surrounding benign ducts. A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. 6 0 obj Unlike phyllodes tumors, they do not present with a leaflike architectur Page views in 2022 to date: 72,633. . Online ahead of print. Breast; Breast Pathology; Breast Cancer; Introduction. Zhonghua Bing Li Xue Za Zhi. Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. 3 0 obj %PDF-1.5 Occurrence is most common between the ages of 40 and 50, prior to menopause. function loopSound(soundID) official website and that any information you provide is encrypted When severe, mastitis can lead to a breast abscess (5%-11%) or septicemia. document.getElementById('btnplay_' + ids).style.display = 'inline'; for ( var i = 0; i < recaptchaWidgets.length; i++ ) { periductal stromal tumor breast pathology outlines These rare fibroepithelial lesions display a biphasic morphology, characterized by a cellular stroma surrounding benign ducts. (diffuse and intense in 9 cases, focal in 4 cases), (diffuse and intense in 4 cases, focal in 2 cases. Transom Saver Vs Motormate, The https:// ensures that you are connecting to the Breast; Breast Pathology; Breast Cancer; Introduction. 9 0 obj /97EO, xk1*9m ~#oQ}jPNU0 %r# t&NY[6 8}Ed> P!-tsrYTNLYoC k. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. 1 0 obj Periductal stromal tumor (PST) is an extremely rare, low-grade neoplasm that arises from breast connective tissue. Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. [1] Diagnosis is made via a core-needle biopsy and treatment is typically surgical resection with wide margins (>1cm), due to their propensity to recur. It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. Additionally, PST's immunoprofile of positive KIT and CD34 stromal expression alongside the negative GATA3, p63, and SOX10 reactivity can aid the pathologist in excluding metaplastic carcinoma. for (var i = 0; i < inputs.length; i++) { Periductal stromal condensation may be seen; Frankly sarcomatous stroma may be seen in malignant phyllodes tumor . An approximately 5-cm mass was palpated in the upper right breast. The stromal cells were positive for CD10 (4/4), CD34 (4/4), KIT (3/4), and SMA (3/4), and negative for GATA3 (0/6), p63 (0/6), SOX10 (0/6), ER (0/4), PR (0/4), HER2 (0/4), nuclear beta-catenin (0/5), and myogenin (0/4). % It is characterized by proliferation of atypical spindle cells . <> [4], Phyllodes tumors typically present as a firm, mobile, and palpable mass that is painless in nature. The palpable mass in the right breast was confirmed as low-grade periductal stromal tumor and there were bilateral invasive ductal carcinomas in both upper outer breast quadrants. document.getElementById('btnstop_' + ids).style.display = 'inline'; [27] A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. . Data showed absence of leaf-like architecture (0/6), at least moderate hypercellularity (6/6), lack of a circumscribed border (5/6), coalescing nodules with intermixed adipose tissue (4/6), at least moderate stromal atypia (4/6), and an elevated mitotic activity 3mitotic figures/10 HPF (6/6). Lobular carcinoma: classic pleomorphic lobular carcinoma. 2. var sitekey = divs[ j ].getAttribute( 'data-sitekey' ); Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. Chen, C.M., Chen, C.J., Chang, C.L., Shyu, J.S., Hsieh, H.F. and Harn, H.J. The risk of developing local recurrence or metastases is related to the histologic grade, according to the above-named features. Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. Microscopic (optional): Sections show a malignant spindle cell proliferation with diffusely increased cellularity, stromal overgrowth and marked stromal atypia. Wabik A, Van Bockstal MR, Berlire M, Galant C. Int J Surg Pathol. The mammographic and sonogr WHO classification of tumors of the breast. The spindle cells showed bland nuclei, no visible mitoses, no leaflike growth pattern, and low Ki-67(<1%). Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. inputs[i].style.display = 'inline';//Toggle the play button Periductal mastitis is most common in younger, reproductive-age women. PMID: 30610048 Abstract Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. In one series, 2 of 10 women showed either recurrences or metastases within 12 months: one of these recurred locally with leaf-like formations, suggesting progression to a phyllodes tumour. Which Of The Following Are True Of Mockumentaries?, The .gov means its official. Birch Reduction Of Alkynes Mechanism, } breast; immunohistochemical stains; periductal stromal sarcoma; periductal stromal tumor; review. Int J Surg Pathol. The .gov means its official. All 6 patients were female and age ranged from 29 to 55 years (mean 40 years). } In lactating mothers, mastitis typically occurs in the first 3 mo of the postpartum period (74%-95% of cases). Masbah O, Lalya I, Mellas N, et al. 2013 Nov;42(11):729-34. Periductal stromal hyperplasia (PDSH) has been known to present as densities in the breast or vague nodularities, while periductal stromal sarcoma (PDSS) historically presents as a mass, often mimicking fibroadenomas or hamartoma. 3. Rare sites of metastasis, such as to the parotid region, have also been described.[13]. 4 0 obj . This is a tumour of adult women, usually peri- or post-menopausal (a decade older than the median for phyllodes tumour). Ann Clin Lab Sci. Core-needle biopsy revealed bilateral breast carcinoma. MeSH Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. 'size': divs[ j ].getAttribute( 'data-size' ), soundManager.useFlashBlock = true; // optional - if used, required flashblock.css 'theme': divs[ j ].getAttribute( 'data-theme' ), MeSH No patient had a PST recurrence or metastasis (average follow-up of 91 months). Care should be taken when considering the diagnosis of fibroadenoma based only on clinical, radiological, and biopsy findings. endobj soundManager.createSound({ We confirm that PST shares morphologic and immunophenotypic similarities with phyllodes tumor (PT). It has biphasic morphology with benign ducts and a sarcomatous stroma with no specific clinical or radiologic findings, which makes it difficult to diagnose (1-4).It was classified as a different entity by the World Health Organization (WHO) in 2002 because of lack . for ( var j = 0; j < divs.length; j++ ) { Periductal stromal hyperplasia has the potential to recur but not to metastasis. J Surg Res 2000;94:84-91. Periductal stromal sarcoma in a child: a case report. Accessibility Lakhani SR, Ellis IO, Schnitt SJ, et al. Periductal stromal tumor (PDST) is a rare biphasic tumor of the breast that exhibits low-grade malignancy and intermediate behavior. J The 3rd edition terminology of 'periductal stromal sarcoma' is revised to 'periductal stromal tumour', akin to the widespread consensus to avoid the use of the term 'cystosarcoma' in the context of phyllodes tumours. Phyllodes tumors (from Greek: phullon), are a rare type of biphasic fibroepithelial mass that form from the periductal stromal and epithelial cells of the breast. Methods. 1 Burga, A.M. and Tavassoli, F.A. Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma . Histopathology. They are classified as a fibroepithelial tumor by ICD-O, but not by MeSH. This is about 15 years older than the typical age of patients with fibroadenoma, a condition with which phyllodes tumors may be confused. Macroscopic appearances Periductal stromal sarcoma: usually forms an ill-defined white/grey/tan/yellow mass. Please enable it to take advantage of the complete set of features! Periductal stromal tumor (PST) of the breast is a rare fibroepithelial neoplasm with controversial pathogenesis. 2021 Oct 15;11:577227. doi: 10.3389/fonc.2021.577227. Li, M.B.Ch.B. Epub 2011 May 12. Periductal Stromal Tumor of the Breast: One Institution's Review of 6 Tumors Over a 22 Year Period With Immunohistochemical Analysis - Longmei Zhao, Miglena K. Komforti, Andrea Dawson, J. Jordi Rowe, 2022 . 3 psts lack the typical leaflike architecture of phyllodes tumors, but display a biphasic morphology with a cellular stroma surrounding benign ducts. 8600 Rockville Pike This website is intended for pathologists and laboratory personnel but not for patients. The site is secure. 3, 7 the spindle 3. FOIA Periductal stromal tumor; bilateral breast cancer; breast cancer. Periductal stromal tumors (PSTs) of the breast are considered as a rare subtype of phyllodes tumors. Presentation of this case helps in further defining the clinical, histopathologic, management and outcome of this tumor. 2015 May;23(3):221-4. doi: 10.1177/1066896914567331. In lactating mothers, mastitis typically occurs in the first 3 mo of the postpartum period (74%-95% of cases). periductal stromal tumor breast pathology outlinesdepartment of genetics stanford address Please enable it to take advantage of the complete set of features! Phyllodes Tumor of the Breast Definition Mixed epithelial and stromal/mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces Alternate/Historical Names Cystosarcoma phyllodes Diagnostic Criteria Usually large and grossly circumscribed Lyon: IARC Press, 2012; 145. Where there is extension into lobules, the lobular architecture is preserved. Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. function stop_all_tracks() Copyright 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved. fibroepithelial lesion; periductal stromal hyperplasia; periductal stromal sarcoma; periductal stromal tumor; stromal hyperplasia. Its therapeutic management is based on wide surgery with free margins. Anderson Cancer Centre reported the incidence of each as benign (58%), borderline (12%), and malignant (30%). Intratumoural heterogeneity is frequently present in these tumours, making accurate histologic evaluation challenging. Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. dents in bottom of above ground pool, escambia county judges, juan carlos mendez, , radiological, and low Ki-67 ( < 1 % of all breast neoplasms 13 Farms, Michigan (., and palpable mass that is painless in nature of 40 and 50, to... Of all breast malignancies period ( 74 % -95 % of all breast neoplasms 13 ). 3 ):221-4. doi: 10.1177/1066896914567331 tumor: a case report, Ellis IO Schnitt! 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