PMC9623357_01
(A) The malignant phyllodes tumor of breast showed stromal overgrowth (arrow;
H&E, 100x). (B) The stroma of the phyllodes tumor showed atypia and
frequent mitotic figures (arrow; H&E, 400x).
10.1177_23247096221133197-fig1.jpg
PMC9623357_01_10.1177_23247096221133197-fig1.jpg
fig1-23247096221133197
Microscopically, the tumor nodules showed fibroepithelial neoplasm with features including areas of stromal overgrowth (Figure 1A). The stroma showed hypercellularity with nuclear atypia and increased mitotic activity (up to 10-14 mitoses per 10 high-power fields were counted in areas of stromal overgrowth; Figure 1B).
Computed tomography scan of the thorax with contrast showing large left-sided
pleural effusion and multiple soft tissue masses in bilateral lung lobes
(red arrows).
10.1177_23247096221133197-fig2.jpg
PMC9623357_01_10.1177_23247096221133197-fig2.jpg
fig2-23247096221133197
Ten months later, the patient presented for dyspnea and was found to have a large left-sided pleural effusion and multiple soft tissue masses in bilateral lung lobes (Figure 2).
(A) The pleural biopsy showed metastatic phyllodes tumor characterized by
sheets of spindle cells (H&E, 100x). (B) The spindle cells showed
significant nuclear atypia (H&E, 400x).
10.1177_23247096221133197-fig3.jpg
PMC9623357_01_10.1177_23247096221133197-fig3.jpg
fig3-23247096221133197
Microscopically, sections showed sheets of malignant spindle cells with features including hypercellular stroma with nuclear atypia, similar to the primary malignant phyllodes tumor (Figure 3A and 3B).
T2 MRI brain showing 5 mm enhancing lesion in the right parietal lobe (red
arrow).. Abbreviation: MRI, magnetic resonance imaging.
10.1177_23247096221133197-fig4.jpg
PMC9623357_01_10.1177_23247096221133197-fig4.jpg
fig4-23247096221133197
The magnetic resonance imaging (MRI) of the brain was significant for a 5 mm T2 hyperintense enhancing lesion in the right parietal lobe (Figure 4), also concerning for metastatic disease.