PMC4899552_01
61-year-old female with neurofibroma of the right breast shows a 2.6 cm, equal-density, circumscribed mass (arrow) with partially obscured posterior margins in the posterior right-upper-outer quadrant. A. Craniocaudad view.B. Mediolateral oblique view.
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Screening mammography and further mammographic workup (Fig. 1) showed a mass in the right breast.
A. 61-year-old female with neurofibroma of the breast. Sonogram of the right breast. Arrows indicate the margin of the pectoralis muscle. The mass (m) abuts the chest wall, but is present within the breast. Parenchymal breast tissue and fat are seen above the mass. B. Parenchymal breast tissue and fat are seen above the mass.
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Figure 2 shows the sonographic features of this mass.
61-year-old female with neurofibroma of the breast. Sonogram of the right breast, showing an aspiration needle (arrow) within the mass (m).
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Eight days after her initial presentation, the patient underwent attempted aspiration of the mass (Fig. 3) under sonographic guidance.
61-year-old female with neurofibroma of the breast. A. Pre-fire core biopsy image. The needle tip (arrow) is within the breast at the leading edge of the mass (m). The mass is clearly seen to be located within the breast, with normal breast parenchyma surrounding the mass. B. Post-fire core biopsy image with the needle (arrows) passing through the mass (m). The needle passes through breast tissue, then through the mass, confirming the location of the mass within the breast.
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The mass was then determined to be solid, and ultrasound-guided core biopsy of the mass was performed using a spring-loaded needle system (Fig. 4).
A&B. 61-year-old female with neurofibroma of the breast. A and B. Hematoxylin and eosin stains at intermediate power.
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Microscopically, the biopsy revealed a circumscribed, moderately cellular spindle-cell neoplasm, abutting a portion of skeletal muscle (Fig. 5).
61-year-old female with neurofibroma of the breast. Immunostain at high power, showing many cells reactive with S-100 protein (darker cells).
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The spindle cells had markedly elongated nuclei with a wavy configuration and pointed ends, many reactive with S-100 protein (Fig. 6).