Significant histologic features differentiating cellular fibroadenoma from phyllodes tumor on core needle biopsy specimens

Saba Yasir, Roberto Gamez, Sarah Jenkins, Daniel W. Visscher, Aziza Nassar

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Objectives: Cellular fibroepithelial lesions (CFELs) are a heterogeneous group of tumors encompassing cellular fibroadenoma (CFA) and phyllodes tumor (PT). Distinction between the two is challenging on core needle biopsy (CNB) specimens. The objective of this study was to evaluate histologic features that can help distinguish PT from CFA on CNB specimens.

Methods: Records of all patients diagnosed with CFELs on CNB specimens with follow-up excision between January 2002 and December 2012 were retrieved. Histopathologic stromal features were evaluated on CNB specimens, including mitoses per 10 high-power fields (hpf), overgrowth, increased cellularity, fragmentation, adipose tissue infiltration, heterogeneity, subepithelial condensation, and nuclear pleomorphism.

Results: Twenty-seven (42.2%) of 64 were diagnosed as PT (24 benign PTs and three borderline PTs) and 37 (57.8%) as CFA on excision. All features except for increased stromal cellularity were statistically significant. The average number of histologic features seen in PT and CFA was 3.9 and 1.4, respectively (odds ratio [OR], 7.27; 95% confidence interval [CI], 2.44-21.69; P = .0004). The average number of mitoses per 10 hpf was 3.0 for PT compared with 0.8 for CFA (OR, 2.14; 95% CI, 1.18-3.86; P = .01).

Conclusions: The presence of mitoses (three or more) and/or total histologic features of three or more on CNB specimens were the most helpful features in predicting PT on excision.

Original languageEnglish (US)
Pages (from-to)362-369
Number of pages8
JournalAmerican journal of clinical pathology
Volume142
Issue number3
DOIs
StatePublished - Sep 1 2014

Keywords

  • Biopsy specimens
  • Fibroadenoma
  • Fibroepithelial lesions
  • Needle cores
  • Phyllodes tumor

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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