PMC4824323_01
(A-C) Core needle biopsy. Depicting stromal prominence and closely packed acini lined by vacuolated cells characteristic of lactational changes with features suggestive of phyllodes tumor (100 x).
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Further workup included a core biopsy (Fig. 1A-C) that revealed a neoplastic lesion with leaf-like configuration lined by bilayered epithelial and myoepithelial cells and cellular fibrous stroma.
Gross photograph of the specimen demonstrating a grayish-white well-circumscribed mass with solid and cystic areas.
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The specimen consisted of a large grayish-white soft tissue mass measuring 10 cm x 9 cm x 4 cm covered on one aspect by a small ellipse of skin measuring 6 cm x 3 cm (Fig. 2).
Benign phyllodes tumor with classic leaf-like fibroepithelial proliferation (40 x).
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Multiple sections following extensive sampling, reviewed, exhibited slit-like ductal spaces lined by bilayered epithelial and myoepithelial cells with stromal hyperplasia (Fig. 3).
(A) Benign phyllodes tumor with characteristic expansile stroma (40 x). (B) Black arrow depicts increased stromal cellularity in close proximity to the epithelium. Brown arrow depicts reduced stromal cellularity away from the epithelium (100 x). (C) Another area of tumor (400 x). Black arrow depicts increased stromal cellularity in close proximity to the epithelium. Brown arrow depicts reduced stromal cellularity away from the epithelium.
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There were foci demonstrating expansile stroma with periductal accentuation (Fig. 4A-C) and extensive areas of hyalinization.
Benign phyllodes tumor with lactational changes demonstrating lobules of closely packed acini lined by vacuolated secretory epithelium with sparse intervening stroma (40 x).
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The luminal epithelial cells demonstrated secretory vacuoles (Fig. 5).