PMC4534750_01
Myofibroblastoma of the breast of an 80-year-old man. A left, mediolateral oblique mammogram revealed a well-defined, moderate density mass (arrows) in the upper inner quadrant of the left breast.
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The MG showed a 3.0 x 2.0 cm well-defined, round-shaped, medium-density mass in the upper portion of the left breast but no associated calcifications or architectural distortion (Figure 1) nor gynecomastia.
Magnetic resonance imaging findings of the breast mass. (a) T1-weighted spin echo MR image shows a focal mass with low signal intensity and smooth borders. (b) The fat-suppressed fast spin echo T2-weighted MR image shows a focal mass with high signal intensity. (c) Gd-enhanced fat-suppressed T1-weighted MR image shows strong heterogeneous enhancement of the mass and linear areas of low signal intensity in keeping with internal septations. (d) ADC value of the mass.
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The signal intensity of the mass showed hypointense on precontrast T1-weighted MR (Figure 2(a)) and hyperintense on T2-weighted images (Figure 2(b)). Gd-enhanced fat-suppressed T1-weighted MR images showed early strong enhancement of the mass with nonenhancing internal septations (Figure 2(c)). The lesion ADC value was 2.280 x 10-3 mm2/s (Figure 2(d)).
Axial 18-fluorine deoxyglucose positron emission tomography (18F-FDG-PET)/computed tomography (CT) fusion images and PET/CT fusion sections showing focal minimal FDG uptake in left breast.
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In the upper-left inner quadrant of his breast a round-shaped, nodular lesion was detected with a 12 mm diameter and a hypodense center with low FDG uptake (SUV max: 1.2) (Figure 3).
Pathologic findings of the breast lesions. (a) Overall appearance: tumor cells arranged in single file reminiscent of invasive lobular carcinoma (H&E x200). (b) Negative for pankeratin (IHC x100). (c) Estrogen receptor positivity (IHC x100).
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Its histologic appearance resembled an invasive lobular carcinoma (Figure 4(a)). Immunohistochemistry revealed that the tumor cells were negative for keratin (Figure 4(b)) but positive for antismooth muscle actin and estrogen receptor (Figure 4(c)).