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Breast-nonmalignant
Inflammatory / infectious
Reactive spindle cell nodule
Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)
Revised: 28 September 2012, last major update April 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Benign spindle cell tumor, rare complication of breast core biopsy or fine needle aspiration (Am J Clin Pathol 1991;96:76)
● Similar to counterparts in bladder, prostate or other GU sites, but few publications in breast
Terminology
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Epidemiology
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Sites
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Etiology
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● May be due to exuberant reparative process
Clinical features
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● Associated with biopsy of complex sclerosing lesions and papillary lesions (Am J Clin Path 2000;113:288)
Prognostic factors
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Case reports
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● 52 year old woman with mass arising post-Mammotome (Pathol Int 2008;58:787)
Treatment
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Clinical images
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Gross description (Macroscopy)
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● Up to 1 cm, nodular, not encapsulated
Gross images
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Micro description (Histopathology)
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● Myofibroblastic spindle cells with mild/moderate nuclear pleomorphism, small vessel proliferation, foam cells, lymphocytes, hemosiderin
Micro images
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Bladder: myofibroblasts in
myxoid matrix
Drawings
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Virtual Slides
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Videos
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Cytology description
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Cytology images
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Positive stains
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Spindle cells:
● Smooth muscle actin, muscle specific actin
Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● Fibromatosis: spindle cells form interlacing fascicles with variable collagen deposition and cellularity; usually extends into surrounding fat and glandular parenchyma
● Inflammatory myofibroblastic tumor: prominent inflammatory infiltrate, not post-operative
● Leiomyosarcoma: no recent history of biopsy or surgery; often marked atypia and necrosis
● Low grade sarcoma
● Low grade spindle cell carcinoma
● Myofibroblastoma: uniform, bland spindle cells haphazardly arranged in fascicles with pushing borders, separated by broad bands of hyalinized collagen
● Nodular fasciitis: superficial, well circumscribed, zonation effect with hypocellular central region and hypercellular periphery; feathery, tissue-culture like growth pattern due to abundant ground substance; often with mucoid pools (microcysts)
Additional references
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End of Breast-nonmalignant > Inflammatory / infectious > Reactive spindle cell nodule
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