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Difference between revisions of "Breast pathology"
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→Phyllodes tumour
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==Phyllodes tumour== | ==Phyllodes tumour== | ||
===General=== | ===General=== | ||
*The name comes from the word "leaf". | |||
**With imagination or psychotropic drugs, it may look like one: the epithelial component = the veins of the leaf. | |||
*Wide excision -- this differs from fibroadenoma (just local excision). | *Wide excision -- this differs from fibroadenoma (just local excision). | ||
*Approximately 6% are malignant.<ref name=pmid12689668>{{cite journal |author=Guerrero MA, Ballard BR, Grau AM |title=Malignant phyllodes tumor of the breast: review of the literature and case report of stromal overgrowth |journal=Surg Oncol |volume=12 |issue=1 |pages=27–37 |year=2003 |month=July |pmid=12689668 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0960740403000057}}</ref> | *Approximately 6% are malignant.<ref name=pmid12689668>{{cite journal |author=Guerrero MA, Ballard BR, Grau AM |title=Malignant phyllodes tumor of the breast: review of the literature and case report of stromal overgrowth |journal=Surg Oncol |volume=12 |issue=1 |pages=27–37 |year=2003 |month=July |pmid=12689668 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0960740403000057}}</ref> | ||
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===Microscopic=== | ===Microscopic=== | ||
Features: | Features - either 1, 2 or both of the following: | ||
#Large slit-like spaces - '''key feature'''. † | |||
#Cellular stroma - '''key feature'''. † | |||
#*May be [[myxoid stroma|myxoid]]. | |||
*+/-Infiltrative border. | |||
*+/-Mitoses. | *+/-Mitoses. | ||
* | *+/-Nuclear atypia. | ||
*+/-"Stromal overgrowth" ~ stroma fills microscopic field. | |||
Notes: | |||
* † Large slit-like spaces are required for a benign phyllodes tumour. | |||
** Slit-like spaces may absent in a borderline phyllodes ''or'' a malignant phyllodes. | |||
** A cellular tumour without features suggestive of malignancy and without slit-like spaces is a ''[[cellular fibroadenoma]]''. | |||
DDx: | |||
*[[Fibroadenoma]]. | |||
*Sarcoma. | |||
Images: | |||
*[http://en.wikipedia.org/wiki/File:Phyllodes_tumour_-_very_low_mag.jpg Phyllodes tumour - very low mag. (WC)]. | *[http://en.wikipedia.org/wiki/File:Phyllodes_tumour_-_very_low_mag.jpg Phyllodes tumour - very low mag. (WC)]. | ||
*[http://en.wikipedia.org/wiki/File:Phyllodes_tumour_-_low_mag.jpg Phyllodes tumour - low mag. (WC)]. | *[http://en.wikipedia.org/wiki/File:Phyllodes_tumour_-_low_mag.jpg Phyllodes tumour - low mag. (WC)]. | ||