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Cha, Choi, Youn, Kim, and Moon: Extensive Squamosu Metaplasia Mimicking Squamous Cell Carcinoma in Fibroadenoma
Case Report
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 76(1): 56-60.

Published online: 31 January 2009

DOI: https://doi.org/10.4174/jkss.2009.76.1.56

Extensive Squamosu Metaplasia Mimicking Squamous Cell Carcinoma in Fibroadenoma

Eun Jung Cha, M.D., Keum Ha Choi, M.D., Hyun Jo Youn, M.D., Ph.D.1, Dong Sug Kim, M.D., Ph.D.2, Woo Sung Moon, M.D., Ph.D.

Department of Pathology, Chonbuk National University Medical School, Jeonju, Korea.

1Department of Surgery, Chonbuk National University Medical School, Jeonju, Korea.

2Institute for Medical Sciences, and Kim's Pathology Clinic, Daegu, Korea.

mws@chonbuk.ac.kr

Received 21 May 2008       Accepted 29 July 2008

Copyright © 2009 The Korean Surgical Society

Abstract

We report a fibroadenoma with extensive squamous metaplasia in the breast. A 21-year-old woman presented with a mass of the left breast. Breast ultrasonography showed a 1.8×1.7 cm sized, well-circumscribed mass in left subareolar region. The mass was excised. Grossly, the mass was well circumscribed and the cut surfaces were grayish-white in color and elastic in consistency. Microscopically, the breast lesion showed the histological features of fibroadenoma. There were areas of extensive squamous metaplasia seen as isolated clusters or involving duct. But some metaplastic clusters surrounded by fibrous stroma were compressed and distorted and separation of cells into isolated clusters mimicked invasive carcinoma. Co-expression of CK 5/6, high molecular weight CK and p63 in areas of squamous metaplasia and normal myoepithelial cells supported myoepithelial cell origin of metaplastic cells.

Keywords: Breast, Fibroadenoma, Squamous metaplasia

Figures and Tables

Fig. 1
Breast ultrasonography showing a well-circumscribed mass in left subareolar region.
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Fig. 2
(A) Extensive squamous metaplasia showing large sheet, isolated nest or involving duct (H&E stain, ×100). (B) Small clusters of epithelial cells surrounded by fibrous tissue and fibrous distortion resembled infiltrative carcinoma (H&E stain, ×400). (C) Mitotic activity is identified up to 4/high power field in some area of squamous metaplasia (H&E stain, ×400). (D) Involving ducts shows transition zone with squamous metaplastic cells apparently arising from basal cells (H&E stain, ×100).
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Fig. 3
Immunostaining for p63 (A, ×100), CK 5/6 (B, ×100) and HMWCK (C, ×100) was strong in areas of squamous metaplasia and in basal cells of duct. Ki-67 proliferation rate was less than 5% (D, ×400). Avidin-biotin-conjugate (ABC) method.
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Table 1
Results of immunohistochemical staining
jkss-76-56-i001

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