Breast Metaplastic Spindle Cell Carcinoma And Its Mimics: An Update Through The Discussion On Real Case | 45242
Journal of Clinical & Experimental Pathology
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Metaplastic carcinoma is the malignant neoplasm that exhibits microscopic structural changes, which diverge from glandular
differentiation. It is a heterogeneous group of tumors. The 2012 WHO classification based on the descriptive morphology has
divided it into several different sub-groups, among which, spindle cell carcinoma (including fibromatosis-like metaplastic carcinoma)
represents the most diagnostic challenge to pathologists, especially on core biopsies. Many breast lesions/tumors could present,
at least focally, as spindle cell morphology. However, their clinical significance is greatly different, which makes the differential
diagnosis very critical. The spectrum could at one end consist of hypertrophic scar/pseudoangiomatous stromal hyperplasia/
nodular fascitis, the lesions mostly considered as a reactive/repair process, while the other end malignant phyllodes tumor/malignant
adenomyoepithelioma/mesenchymal sarcomas. Previous malignant myoepithelioma/myoepithelial carcinoma is now believed to be
part of the spindle cell carcinoma. The morphological overlapping among these lesions sometimes could be overwhelming. A panel
of markers for immunohistochemical stain is recommended, but they may not always be helpful. This presentation will use five real
cases to discuss the detailed morphological features and immunohistochemical patterns of metaplastic spindle cell carcinoma and its
mimics, including the key points for differential diagnoses.
Xi Wang has completed her Medical education in the Sun Yet-Sen University Medical School in China. She then went to Harvard School of Public Health to be the Research Fellow and later became Research Associate. She has also completed her Residency training in Pathology in West Virginia University and Fellowship training in Sloan- Kettering Cancer Center. She is currently the Associate Professor in Department of Pathology in University of Rochester Medical Center, with the major interests in breast and GYN pathology.