유방 엽상종양의 세포조직학적 비교분석 - 17예에 대한 연구 - = Cytohistologic Correlation of Phyllodes Tumors of the Breast - A Study on 17 Cases -

다국어 초록 (Multilingual Abstract)

Phyllodes tumor (PT) is a rare fibroepithelial tumor of the breast, and these tumors are subdivided into benign, borderline, and malignant tumors. The criteria for their histologic diagnosis have been relatively well-described. However, the cytologic diagnosis presents more difficulties and only a few cytologic studies concerned with their subclassification have been published. The objective of the current study is to describe the cytologic features of benign, borderline and malignant PTs in an attempt to distinguish one from the others. Cytohistologic correlation for 11 benign, 3 borderline and 3 malignant PTs was performed. For all these cases, the preoperative fine needle aspiration (FNA) findings were available for review. The features we examined were a necrotic background, cellularity, stromal tissue fragments, stromal pleomorphism and atypism, dissociated stromal cells and mitosis. The overall diagnostic accuracy of FNA for the PT grading was 88.2% (15/17). Two benign PTs were cytologically misinterpreted as ‘‘atypical epithelial and stromal cells’’ and ‘‘highly suspicious for ductal carcinoma’’. Nevertheless, the cytologic diagnosis and the grading of PTs on FNA were relatively reliable. Semiquantitative analysis for the cellular stromal tissue fragments, stromal pleomorphism and atypism, dissociated stromal cells and mitosis might be helpful for subclassifing PTs on FNA. In the case of encountering a markedly necrotic background, special concern about degenerative change such as infarction is needed.

참고문헌 (Reference)

1 Tavassoli FA, "WHO classification of tumors; pathology and genetics of tumours of the breast and female genital organs" IARC Press 100-103, 2003

2 Salvadori B, "Surgical treatment of phyllodes tumors of the breast" 63 : 2532-2536, 1989

3 Shabb NS, "Phyllodes tumor: fine needle aspiration cytology of eight cases" 41 : 321-326, 1997

4 Bhattarai S, "Phyllodes tumor of the breast. A Cytohistologic study of 80 cases" 44 : 790-796, 2000

5 Verslegers I, "Massive infarction of a recurrent phyllodes tumor of the breast; MRI-findings" 87 : 21-22, 2004

6 Jayaram G, "Fine-needle aspiration cytology of phyllodes tumors" 26 : 222-227, 2002

7 Dusenbery D, "Fine needle aspiration cytology of phyllodes tumor. Potential diagnostic pitfalls" 36 : 215-221, 1992

8 Rosen PP, "Fibroepithelial tumors. in: Rosen’s breast pathology" Lippincott-Raven 155-171, 1997

9 Harris JR, "Diseases of the breast" Lippincott-Raven Publishers 863-869, 1996

10 Harris JR, "Diseases of the breast" Lippincott-Raven Publishers 863-869, 1996

11 Page DL, "Diagnostic histopathology of the breast" Churchill Livingstone 341-350, 1987

12 Suh JH, "Cytologic features of benign phyllodes tumors as compared to fibroadenomas of the breast" 7 : 151-156, 1996

13 Shimizu K, "Cytologic evaluation of phyllodes tumors as compared to fibroadenomas of the breast" 36 : 215-221, 1992

14 Rao CR, "Cystosarcoma phyllodes: diagnosis by fine needle aspiration cytology" 36 : 203-207, 1992

15 Pietruszka M, "Cystosarcoma phyllodes: a clinicopathologic analysis of 42 cases" 41 : 1974-1983, 1978

16 Veneti S, "Benign phyllodes tumour vs fibroadenoma:FNA cytological differentiation" 12 : 321-328, 2001

17 Koss LG, "Aspiration biopsy: Cytologic interpretation and histologic bases" Igaku-Shoin Inc 141-, 1992