Breast - nonmalignant
Benign tumors / changes
Hemangiopericytoma of breast

Author: Monika Roychowdhury, M.D. (see Authors page)

Revised: 16 March 2016, last major update March 2016

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Hemangiopericytoma [title] breast
Definition / General
  • Rare, low grade malignant tumor with circumscribed area of bland spindled cells with branching and staghorn vessels
  • Originally regarded as a vascular, pericyte derived tumor; recently categorized by WHO as a fibroblastic tumor similar to solitary fibrous tumor
Essential Features
  • Low grade malignant tumor composed of branching / staghorn vessels and bland spindled cells
  • Complete excision with negative margins is considered curative
  • Aggressive behavior suggested if large (> 5 cm), necrosis, mitosis, infiltrative margins
Terminology
Epidemiology
  • Very rare
  • Usually women 33 - 67 years
Pathophysiology
  • Originates from capillary pericytes
Clinical Features
  • Painless, firm nodule / mass, not attached to the skin
Radiology Images

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Well circumscribed mass

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Hypoechoic lesion

Prognostic Factors
  • Nuclear atypia, high cellularity or necrosis, increased mitotic index (>4/10 HPF), large tumor size (>5 cm) and infiltrative margins are considered criteria for malignancy, and also correlate with local recurrence and metastatic disease
Case Reports
Treatment
  • Complete local excision with negative margins
  • Inadequate data regarding lymph node dissection; in general, lymph node metastases are rare
  • Mastectomy may be necessary for large lesions (Mod Pathol 1988;1:98)
Micro Description
  • Thin walled, staghorn-type vessels separated by polygonal cells with indistinct margins, pale cytoplasm and small round/oval nuclei
  • May have areas of hemorrhage and cystic degeneration
  • Variable mild increase in mitosis
Micro Images

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Thin walled staghorn-type vessels

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Reticulin



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Fusiform tumor cells

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CD34 and vimentin

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Pectoralis major mass

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Sinonasal tumor

Cytology Description
  • Cellular
  • Single and tightly packed clusters of oval to spindled cells aggregating around branched capillaries
  • Usually basement membrane material is present
  • Nuclei are uniform and oval with finely granular chromatin and indistinct nucleoli
  • No mitotic figures, no necrosis (Cancer 1999;87:190)
  • Positive Stains
    Negative Stains
    Electron Microscopy Description