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Breast-nonmalignant

Benign tumors / changes

Leiomyoma

 

Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)

Revised: 8 October 2012, last major update April 2010

Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.

 

Definition

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● Benign smooth muscle tumor similar to counterparts elsewhere

 

Terminology

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Epidemiology

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● Rare in breast

 

Sites

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● Usually involves nipple

 

Etiology

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● Usually contiguous with muscular components of nipple areolar complex (J La State Med Soc 1998;150:367)

 

Clinical features

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● Superficial or deep (vascular)

● Often painful (Am J Surg Pathol 1979;3:151)

 

Prognostic factors

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Case reports

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● 23 year old woman with hyperkeratotic subareolar leiomyoma (Ann Dermatol Venereol 2008;135:571)

● 42 year old woman with epithelioid leiomyoma with granular cell change (Hum Pathol 1993;24:1260)

● 47 year old woman with tumor of breast parenchyma (AJR Am J Roentgenol 2005;185:1595)

● Tumor of nipple (Breast J 2006;12:377)

 

Treatment

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● Complete excision to prevent recurrence

 

Clinical images

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Gross description (Macroscopy)

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● Often ill-defined

 

Gross images

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Micro description (Histopathology)

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● Interlacing bundles of spindle cells with eosinophilic cytoplasm and blunt ended, cigar shaped nuclei

● May have epithelioid or granular features

● No atypia, no hypercellularity, no/rare mitotic figures (<3 per 10 HPF), no necrosis

 

Micro images

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Circumscribed tumor of spindled

cells without atypia

 

 

                                Various images

Fascicles of spindle cells with abundant

eosinophilic cytoplasm and blunt ended nuclei

 

 

               

Smooth muscle actin positive

 

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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● Smooth muscle actin, desmin, vimentin

 

Negative stains

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● S100, keratin

 

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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Hamartoma: also adipose and epithelial elements

Leiomyosarcoma: infiltrating tumor with pleomorphism, atypia, necrosis (Diagn Pathol 2006;1:13)

 

Additional references

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End of Breast-nonmalignant > Benign tumors / changes > Leiomyoma

 

 

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