Myofibroblastoma and solitary fibrous tumour of the breast: histopathologic and immunohistochemical studies

Thirteen mesenchymal tumours of the breast were reviewed histologically and immunohistochemically. Nine tumours (male:female ratio 5:4, average age 64 years) were classified as myofibroblastomas and presented as a single nodule (four) or a multilobular mass (five). They were composed of elongated cells with vesicular nuclei showing grooves, intranuclear inclusion, and small but conspicuous nucleoli resembling myofibroblasts seen in scar tissue. In six tumours, hypercellular zones alternated with paucicellular, hyalinized areas. The collagen pattern was dense, diffuse, and brightly eosinophilic in all neoplasms. The tumour cells were positive for desmin, actin, and vimentin in all nine lesions, and in six tumours a focal CD 34 positivity was also demonstrated. Four tumours (four female patients, average age 75 years) were classified as solitary fibrous tumours and consisted of well-circumscribed nodules. They were characterized by a monomorphic population of thin, spindled to ovoid cells with finely dispersed chromatin and inconspicuous nucleoli. The pattern of the collagen in these tumours was one of thick, brightly eosinophilic bands. These four tumours were negative for all markers tested except vimentin and CD 34. Although myofibroblastomas and solitary fibrous tumours of the breast share many morphologic features, there are enough differences in their cytologic composition and, most importantly, in their immunohistochemical profile to consider them as distinct entities.