Malignant fibrous histiocytoma of the chest wall masquerading as medullary breast carcinoma: a case report.
BACKGROUND
Cytologic diagnosis of malignant fibrous histiocytoma can be problematic, as these neoplasms are known to mimic multiple other conditions.


METHODS
A fine needle aspirate from a 60-year-old woman was diagnosed at 2 institutions as medullary carcinoma of the breast. The patient received neo-adjuvant chemoradiotherapy before the tumor war excised. Gross pathologic examination and histomorphology on routine staining were compatible with the cytologic diagnosis. The accurate diagnosis of pleomorphic-storiform-type malignant fibrous histiocytoma was a surprise and was established with immunocytochemical stains. In retrospect, it was thought that clinical and radiologic overlap, creating a high index of suspicion for a breast neoplasm and compounding the cytologic appearance of a medullary carcinoma with spindle cell metaplasia and syncytial cells, was responsible for the error.


CONCLUSIONS
This case highlights a potential cytodiagnostic pitfall and the importance of establishing a definitive tissue diagnosis in the face of equivocal cytologic findings.
Sharma
Prashant
P
Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India. prashant_sharma@msn.com
Jain
Shyama
S
Nigam
Sonu
S
Bahadur
Anil Kumar
AK
Ouseph
Madu Micheal
MM
D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D044963:Biopsy, Fine-Needle / Q000592:standards; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000473:pathology; D004396:Coloring Agents; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D005260:Female; D051677:Histiocytoma, Malignant Fibrous / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D011878:Radiotherapy; D035441:Thoracic Wall / Q000473:pathology*; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D004396:Coloring Agents