PMC6880032_01
Pathology: Neoplastic stroma.. H&E stained image demonstrates benign breast epithelium with apocrine
metaplasia. The surrounding stroma represents the neoplastic stroma of the
phyllodes tumor.
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Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
Pathology: Benign breast epithelium.. H&E stained image demonstrates benign breast epithelium with apocrine
metaplasia and usual ductal hyperplasia. The surrounding stroma is
neoplastic.
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Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
Pathology: Pericanalicular growth, 100x.. Pericanalicular growth: H&E stained image demonstrating a pericanalicular
overgrowth of spindle-shaped stromal cells (magnification 100x).
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Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
Pathology: Phyllodes mitoses, 400x.. Phyllodes mitoses: H&E stained image exhibits three mitotic figures and
overgrowth of spindle-shaped stromal cells. Mitotic count was 32 per 10 high
power fields in the most proliferative area. (magnification 400x).
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Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
Pathology: Pericanalicular growth.. Pericanalicular pattern of stromal overgrowth with retained benign breast
epithelial component.
10.1177_2036361319890710-fig5.jpg
PMC6880032_01_10.1177_2036361319890710-fig5.jpg
fig5-2036361319890710
Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
Pathology: Pericanalicular growth.. Pericanalicular pattern of stromal overgrowth with retained benign breast
epithelial component.
10.1177_2036361319890710-fig6.jpg
PMC6880032_01_10.1177_2036361319890710-fig6.jpg
fig6-2036361319890710
Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
Pathology: Malignant osteoid.. Malignant osteoid: H&E stained image shows spindle cells, scattered giant
cells, and malignant osteoid representing the heterologous element of
osteosarcoma in the setting of a malignant phyllodes tumor.
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fig7-2036361319890710
Phyllodes tumors which exhibit a percanalicular and infiltrative pattern are also called periductal stromal sarcomas, thus placing our tumor in this category (Figures 1-7).
Pathology: IHC stain, EMA.. Immunohistochemistry stain for epithelial membrane antigen, negative.
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Multiple immunostains were negative including pancytokeratin (CK AE1/AE3), CK5/6, and EMA, thus eliminating metaplastic carcinoma (Figures 8 and 9).
Pathology: IHC stain, pancytokeratin.. Immunohistochemistry stain for pancytokeratin, negative.
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Multiple immunostains were negative including pancytokeratin (CK AE1/AE3), CK5/6, and EMA, thus eliminating metaplastic carcinoma (Figures 8 and 9).
Pathology: Skull metastases.. Skull mets: H&E stained image displays numerous atypical spindle and
epithelioid cells with mitosis and malignant osteoid, invading the bone.
This is consistent with metastatic osteosarcoma, to the skull.
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Neurosurgery was consulted and the mass was resected (Figure 12) with the final pathology showing phyllodes tumor with osteosarcomatous elements and clear margins consistent with her original breast diagnosis (Figure 10).
Imaging: MRI axial T1 pre-op.. Axial T1-weighted post-contrast image, from 29/4/2015, shows an avidly
enhancing 3.6-cm right parietal calvarial mass with minimal extension into
the adjacent extra-axial space. There are no additional enhancing
lesions.
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MRI of the brain showed a 3.6-cm right parietal and frontal bone mass with minimal extension into the adjacent extra-axial space favoring metastases (Figure 11).
Imaging: MRI axial T1 post-op.. Axial T1-weighted post-contrast image, from 15/7/2015, shows postsurgical
changes related to a right frontoparietal cranioplasty, without evidence of
nodular enhancement to suggest residual or recurrent tumor.
10.1177_2036361319890710-fig12.jpg
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fig12-2036361319890710
Neurosurgery was consulted and the mass was resected (Figure 12) with the final pathology showing phyllodes tumor with osteosarcomatous elements and clear margins consistent with her original breast diagnosis (Figure 10).