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Special Feature
January 1, 2005

Image of the Month—Diagnosis

Arch Surg. 2005;140(1):96. doi:10.1001/archsurg.140.1.96

Nonepithelial lesions of the breast have been broken into 2 classes: true sarcomas (malignant fibrous histiocytoma, fibrosarcoma, malignant fibromatosis, leiomyosarcoma, osteogenic sarcoma, chondrosarcoma, liposarcoma, stromal cell sarcoma, and spindle-cell or undifferentiated sarcoma) and others (including angiosarcoma, lymphangiosarcoma, lymphoma, and cystosarcoma phyllodes).1

Stromal sarcomas of the breast are slow-growing, extremely rare mesenchymal tumors with no epithelial components (unlike cystosarcoma phylloides, hemangiosarcoma, and lymphangiosarcoma). Stromal cell sarcoma had previously been defined as “all sarcomas of the breast excluding cystosarcoma phylloides and angiosarcoma,”2 but it has recently been redefined in reference to “rare sarcomas of a nonspecific type that arose in intralobular stroma. Both malignant fibrous histiocytoma and stromal cell sarcoma consist of spindled cells resembling fibroblasts; the only distinguishing feature is the primary involvement of intralobular stroma in the former and extralobular stroma in the latter. This distinction is difficult in proliferating tumors.”2,3