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Inflammatory myofibroblastic tumor of the breast. A case report
Ibrahim M Zardawi1, David Clark, Garvin Williamsz
1Mayne Health, Newcastle Laboratory, P.O. Box 801, Newcastle, NSW 2300, Australia. ibrahim.zardawi@maynegroup.com
Background:
Inflammatory myofibroblastic tumor (IMT) of the breast is a very rare tumor like lesion with only 6 previously reported cases. Very little is known about the cytology of IMT. We present the fine needle aspiration (FNA) cytology of a case of recurrent, bilateral IMT of the breast and detail the clinical course, radiologic findings, morphologic appearances and immunohistochemical profile of the lesion.
Case:
A 79-year-old female was initially seen in 1991 because of a suspicious mammographic abnormality in her right breast. Ultrasound-guided FNA cytology showed an unusual "inflammatory" lesion with occasional aggregates of cellular connective tissue fragments, sheets of uniform ductal epithelial cells with myoepithelial cells, spindle cells, lymphocytes and histiocytelike cells. The lesion was excised, and histology confirmed a benign process with spindle cells, lymphocytes and histiocytes. No malignant features were noted. During follow-up many new lesions appeared in both breasts, and after several FNA procedures and local excisions, bilateral mastectomy was performed at the patient's urging. She remained disease free.
Conclusion:
Although IMT of the breast has benign cytology and histology, clinically and on imaging, it resembles carcinoma. Awareness of the condition may help prevent a false diagnosis of carcinoma.
