Practical approach to diagnosis of bland-looking spindle cell lesions of the breast

Pathologica. 2019 Dec;111(4):344-360. doi: 10.32074/1591-951X-31-19.

Abstract

The diagnosis of bland-looking spindle cell lesions of the breast is often challenging because there is a close morphological and immunohistochemical overlap among the different entities. The present review will discuss reactive spindle cell nodule/exuberant scar, nodular fasciitis, inflammatory pseudotumor, myofibroblastoma (classic type), lipomatous myofibroblastoma, palisaded myofibroblastoma, benign fibroblastic spindle cell tumor, spindle cell lipoma, fibroma, leiomyoma, solitary fibrous tumor, myxoma, schwannoma/neurofibroma, desmoid-type fibromatosis, dermatofibrosarcoma protuberans, low-grade fibromatosis-like spindle cell carcinoma, inflammatory myofibroblastic tumor and low-grade myofibroblastic sarcoma arising in the breast parenchyma. The pathologist should be aware of each single lesion to achieve a correct diagnosis to ensure patient a correct prognostic information and therapy. Accordingly representative illustrations and morphological/immunohistochemical diagnostic clues will be provided.

Keywords: Breast parenchyma; Diagnostic approach; Differential diagnosis; Spindle cell tumors.

Publication types

  • Review

MeSH terms

  • Breast / pathology
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / pathology
  • Carcinoma / diagnosis*
  • Carcinoma / pathology
  • Dermatofibrosarcoma / diagnosis*
  • Dermatofibrosarcoma / pathology
  • Diagnosis, Differential
  • Fasciitis / diagnosis*
  • Fasciitis / pathology
  • Female
  • Fibrosarcoma / diagnosis*
  • Fibrosarcoma / pathology
  • Humans
  • Neoplasms, Muscle Tissue / diagnosis
  • Neoplasms, Muscle Tissue / pathology*
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology