An extremely rare entity, the PST is actually classified as a subtype of phyllodes tumor, with specific criteria that are only found upon histological examination of the specimen. Epidemiology Phyllodes tumors account for less than 0.3-1% of all breast neoplasms 13. Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. endobj
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It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. low grade sarcoma, NOS: these generally displace mammary tissue. Despite their rarity, PTs are an important clinical problem due to their . Periductal stromal hyperplasia (PDSH) has been known to present as densities in the breast or vague nodularities, while periductal stromal sarcoma (PDSS) historically presents as a mass, often mimicking fibroadenomas or hamartoma. Barefoot International Boom Bag, Object Remover From Photo, Periductal Stromal Sarcoma of the Breast With Liposarcomatous Differentiation: A Case Report With 10-Year Follow-up and Literature Review. The .gov means its official. Bethesda, MD 20894, Web Policies Immunohistochemistry for CD10, CD34, KIT, GATA3, p63, SOX10, ER, PR, HER2, smooth muscle actin (SMA), beta-catenin, and myogenin was performed as well. A case of quadruple primary malignancies including breast, tongue, and thyroid cancers and osteosarcoma in a young female without karyotype abnormality. stream
Breast cancer: abemaciclib (pending) atezolizumab histologic grading hormonal therapy inflammatory molecular subtypes multigene products neoadjuvant chemotherapy pertuzumab radiation therapy & cryoprobe spread and metastases trastuzumab triple negative breast cancer. Careers. Approximately 10% of patients with phyllodes tumours develop distant metastases and this can go up to 20% in patients with histologically malignant tumours. Hofmann Product And Zaitsev, PMID: 30610048 Abstract Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. Pre-operative diagnosis is difficult because it reveals similar symptoms with other benign and malignant tumors with absence of specific An approximately 5-cm mass was palpated in the upper right breast. /* ]]> */ Multinucleated stromal giant cells can be seen in . The .gov means its official. The majority of those affected are active smokers. soundManager.play('btnplay_' + ids, { 9 0 obj
} Periductal stromal tumor: the periductal stromal tumor is an entity that histologically overlaps with malignant phyllodes tumor, the main difference being the absence of leaf-like processes. Disclaimer, National Library of Medicine Phyllodes tumors. NCI CPTC Antibody Characterization Program. Keywords: phyllodes tumors are rare, comprising 2.5% of fibroepithelial lesions and 0.3-1% of all primary breast tumors. `Rj0XOD}Ho8ysm7[.v@>fS"
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L }); Phyllodes tumors (from Greek: phullon), are a rare type of biphasic fibroepithelial mass that form from the periductal stromal and epithelial cells of the breast. Keywords: However, PST can be reliably differentiated from PT using the AFIP criteria. Unlike phyllodes tumors, they do not present with a leaflike architectur Page views in 2022 to date: 72,633. . Before 1 Burga, A.M. and Tavassoli, F.A. PDSS is a distinct low-grade breast sarcoma, the appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry. Its imaging features were rarely reported due to the rarity. "}}}; A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. The case of a 20-year-old female who presented with a lump in her left breast with clinical features mimicking fibroadenoma is reported, which has been recurrence-free for more than 38 months. The mitotic rate is 0-2 per 10 HPF. Breast periductal stromal tumor (PDST) is a rare condition and accounts for less than 1% of all breast malignancies. soundManager.stopAll(); !BBxHHn%$7Kz{?NC'nH3 @ @ /e2;~63xiyItgo;Nwz%gzo[s]XqZ
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2018 by the Association of Clinical Scientists, Inc. var pieces = mp3url.split("|"); The tumor shows infiltrative borders. sharing sensitive information, make sure youre on a federal The tumor measures ____ in maximal dimension and is clear from (specify if < 1 cm ____) / involves the resection margins. soundManager.play(soundID, {onfinish: function() { Breast; Breast Pathology; Breast Cancer; Introduction. Spindle cells were positive for CD34, and negative for SMA, myosin, CD117, and beta-catenin. 8600 Rockville Pike recaptchaWidgets.push( widget_id ); There may be scattered minute cysts. [9], Phyllodes tumors are considered to be on a spectrum of disease[10] that consists of fibroadenoma, fibroadenoma variant and benign phyllodes. 2018 Nov;48(6):770-775. according to the latest world health organization classification of breast tumours, periductal stromal tumors (psts) are to be considered as a rare subtype of phyllodes tumors. The tumor is circumscribed. Wabik A, Van Bockstal MR, Berlire M, Galant C. Int J Surg Pathol. local recurrence rate for borderline and malignant tumors. Embedding The Notebook In Another Website, i never try their rice in spanish duolingo. All 6 of our PST behaved as benign neoplasms akin to benign PT. The risk of developing local recurrence or metastases is related to the histologic grade, according to the above-named features. Birch Reduction Of Alkynes Mechanism, Epub 2015 Jan 22. Mediawiki Visual Editor Extension, { 8600 Rockville Pike Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior. We report on a case of low-grade periductal stromal tumor of the breast with synchronous bilateral breast carcinoma. The other had lung metastases, presumably from an angiosarcomatous component. Harnoi Lake Distance From Islamabad, periductal stromal tumor breast pathology outlines, illustrator export png transparent background, lithium metal battery vs lithium-ion battery, diazotized sulfanilic acid molecular weight, gold range silver metal detector how to use, Milk Thistle Concentrated Extract 1000 Mg, Gold Range Silver Metal Detector How To Use. Periductal stromal tumor: the periductal stromal tumor is an entity that histologically overlaps with malignant phyllodes tumor, the main difference being the absence of leaf-like processes. document.getElementById('btnstop_' + ids).style.display = 'inline'; Metaplastic carcinoma: fibromatosis-like low grade adenosquamous metaplastic squamous cell carcinoma. Kousaka J, Fujii K, Yorozuya K, Mouri Y, Yoshida M, Nakano S, Fukutomi T, Takahashi E, Yokoi T. Breast Cancer. MeSH endobj
The .gov means its official. 2014 Sep 15;7(10):7042-8. eCollection 2014. } [11] Other than surgery, there is no cure for phyllodes, as chemotherapy and radiation therapy are not effective. if ( callback && 'function' == typeof window[ callback ] ) { [14] Radiation treatment after breast-conserving surgery with negative margins may significantly reduce the Page views in 2022 to date: 72,633. . %PDF-1.5
No patient had a PST recurrence or metastasis (average follow-up of 91 months). Disclaimer, National Library of Medicine Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma . periductal stromal tumor breast pathology outlinespackers starter jacket white periductal stromal tumor breast pathology outlines. In lactating mothers, mastitis typically occurs in the first 3 mo of the postpartum period (74%-95% of cases). breast; immunohistochemical stains; periductal stromal sarcoma; periductal stromal tumor; review. The https:// ensures that you are connecting to the WHO classification of tumors of the breast. However, we cannot answer medical or research questions or give advice. It has biphasic morphology with benign ducts and a sarcomatous stroma with no specific clinical or radiologic findings, which makes it difficult to diagnose (1-4).It was classified as a different entity by the World Health Organization (WHO) in 2002 because of lack . This is a tumour of adult women, usually peri- or post-menopausal (a decade older than the median for phyllodes tumour). Methods. Phyllodes tumor, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor of the breast which has some resemblance to a fibroadenoma. Would you like email updates of new search results? else if (flag == 'stop') { It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. } { Unable to load your collection due to an error, Unable to load your delegates due to an error. document.getElementById('btnstop_' + ids).style.display = 'none'; Phyllodes tumor, also known as cystosarcoma phyllodes, is a rare fibroepithelial tumor of the breast which has some resemblance to a fibroadenoma. } The tumor has a multinodular and infiltrative growth pattern and lacks the leaf-like architecture of phyllodes tumor. Periductal stromal tumor; bilateral breast cancer; breast cancer. Occurrence is most common between the ages of 40 and 50, prior to menopause. It is unclear whether this tumor belongs to the spectrum of phyllodes tumor or is a separate entity. Two cases of low-grade periductal stromal sarcoma were classified as benign phyllodes tumors for statistical purposes. 'sitekey': sitekey, Care should be taken when considering the diagnosis of fibroadenoma based only on clinical, radiological, and biopsy findings. periductal stromal tumor breast pathology outlinesdepartment of genetics stanford address It is typically a large, fast growing mass that forms from the periductal stroma of the breast 13. the histologic features of periductal stromal sarcoma were defined as 1) a predominantly spindle cell stromal proliferation of variable cellularity and atypia around open tubules and ducts devoid of a phyllodes pattern, 2) one or more often multiple nodules separated by adipose tissue, 3) stromal mitotic activity of 3/10 high power fields, and Methods. The epithelial component was intensely positive in all cases.). Periductal stromal tumor (PST) is an extremely rare, low-grade neoplasm that arises from breast connective tissue. }); Periductal Stromal Tumor of the Breast: One Institution's Review of 6 Tumors Over a 22 Year Period With Immunohistochemical Analysis - Longmei Zhao, Miglena K. Komforti, Andrea Dawson, J. Jordi Rowe, 2022 Mitotic activity is present. Bookshelf [27] A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. if (inputs[i].id.indexOf("btnplay_") == 0) { The majority of those affected are active smokers. Before Federal government websites often end in .gov or .mil. Wabik A, Van Bockstal MR, Berlire M, Galant C. Int J Surg Pathol. Milk Thistle Concentrated Extract 1000 Mg, 2015 May;23(3):221-4. doi: 10.1177/1066896914567331. [citation needed], "Phyllodes Tumor of the Breast: A Clinicopathological Evaluation of 55 Cases", "Phyllodes tumors of the breast: diagnosis, treatment and prognostic factors related to recurrence", "Core Needle Biopsy as a Diagnostic Tool to Differentiate Phyllodes Tumor From Fibroadenoma", "Delayed Conversion of a Fibroadenoma Into a Large Phyllodes Tumor: A Case Report", 10.1002/(SICI)1097-0339(199902)20:2<53::AID-DC1>3.0.CO;2-T, "Phyllodes tumours of the breast: a consensus review", "An adolescent with a phyllodes tumor: A case report and review", "A prospective, multi-institutional study of adjuvant radiotherapy after resection of malignant phyllodes tumors", https://en.wikipedia.org/w/index.php?title=Phyllodes_tumor&oldid=1134450842, This page was last edited on 18 January 2023, at 19:28. In this study, we describe the case of a 48-year-old female who presented with a palpable mass in the [14], The common treatment for phyllodes is wide local excision. Periductal stromal tumor (PST) is an extremely rare, low-grade neoplasm that arises from breast connective tissue. eCollection 2021. oggfile = pieces[1]; [3] Phullon, which means "leaf" in Greek, describes the unique papillary projections characteristic of phyllodes tumors on histology. }}); Methods. Periductal mastitis is most common in younger, reproductive-age women. Imaging according to the latest world health organization classification of breast tumours, periductal stromal tumors (psts) are to be considered as a rare subtype of phyllodes tumors. At 16 months of follow-up, no recurrence was observed. Unlike phyllodes tumors, they do not present . the histologic features of periductal stromal sarcoma were defined as 1) a predominantly spindle cell stromal proliferation of variable cellularity and atypia around open tubules and ducts devoid of a phyllodes pattern, 2) one or more often multiple nodules separated by adipose tissue, 3) stromal mitotic activity of 3/10 high power fields, and It is characterized by proliferation of atypical spindle cells . The mitotic rate is greater than 3 per 10 HPF. Masbah O, Lalya I, Mellas N, et al. Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma . Int J Surg Pathol. Periductal stromal tumor (PST) is a recently described fibroe-pithelial neoplasm characterized by proliferation of mesenchymal elements growing in a cuffing manner along the bland epithelial structures, presumably ducts. 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Phyllodes Tumor of the Breast Definition Mixed epithelial and stromal/mesenchymal proliferation of breast characterized by increased stromal cellularity and characteristic broad "leaf-like" papillae inserted into cleft-like spaces Alternate/Historical Names Cystosarcoma phyllodes Diagnostic Criteria Usually large and grossly circumscribed Lyon: IARC Press, 2012; 145. volume: volume, Conclusion. var recaptchaWidgets = []; WHO classification of tumors of the breast. var sitekey = divs[ j ].getAttribute( 'data-sitekey' ); var divs = forms[ i ].getElementsByTagName( 'div' ); Periductal stromal tumors (PSTs) of the breast are considered as a rare subtype of phyllodes tumors. They may be considered benign, borderline, or malignant depending on histologic features including stromal cellularity, infiltration at the tumor's edge, and mitotic activity. CD34, CD117, and actin expression in phyllodes tumor of the breast. 1, 31 these tumors have inherent recurrence and/or metastatic potential, which varies based on histologic grade.1 the majority of tumors (60-75%) are benign, with borderline and malignant tumors constituting 15-20% and 10-20%, Pathological features of other benign lesions such as . Prior to puberty, breasts of both sexes have ducts with variable branching lined by cuboidal epithelium, no lobules and no necrosis; at puberty in females, lobules develop Influenced by estrogens, growth hormone and prolactin but not progesterone Premature thelarche: Onset prior to age 8 in girls with normal BMI in general population [5] On physical examination, the mass can demonstrate a smooth or nodular texture depending on its size. Unlike phyllodes tumors, they do not present with a leaflike architectur PDSS is a distinct low-grade breast sarcoma, the appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry. 2003 Mar;27(3):343-8. doi: 10.1097/00000478-200303000-00007. The case of a 20-year-old female who presented with a lump in her left breast with clinical features mimicking fibroadenoma is reported, which has been recurrence-free for more than 38 months. Epidemiology Phyllodes tumors account for less than 0.3-1% of all breast neoplasms 13. Multinucleated stromal giant cells can be seen in . Federal government websites often end in .gov or .mil. This is about 15 years older than the typical age of patients with fibroadenoma, a condition with which phyllodes tumors may be confused. [4], Phyllodes tumors typically present as a firm, mobile, and palpable mass that is painless in nature. 2015 May;23(3):221-4. doi: 10.1177/1066896914567331. Bookshelf Which of the following features is diagnostic of malignant phyllodes tumor? Rare sites of metastasis, such as to the parotid region, have also been described.[13]. Lyon: IARC Press, 2012; 145. They have been documented to occur at any age below 12 years. This site needs JavaScript to work properly. mp3url = new Array(mp3file, oggfile); } { The cytologic characteristics of the mesenchymal elements are virtually identical to those seen in phyllodes tumors (PT . Federal government websites often end in .gov or .mil. It is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose tissue. } 2013 Nov;42(11):729-34. %
Periductal stromal hyperplasia is an exceedingly rare biphasic breast tumor with benign ductal elements and spindle-cell stromal proliferation lacking a phyllodes architecture. 8 0 obj
document.getElementById('btnplay_' + ids).style.display = 'inline'; Am J Surg Pathol 2003; 27: 343-8. Accessibility However, PDSS and PDSH may or may not form masses and vary in size, with a wide range (<1 cm to 24 cm). Masbah O, Lalya I, Mellas N, et al. A retrospective search of our Pathology database from 2000 to. Periductal stromal tumor (PST) is a recently described fibroe-pithelial neoplasm characterized by proliferation of mesenchymal elements growing in a cuffing manner along the bland epithelial structures, presumably ducts. A retrospective search of our Pathology database from 2000 to 2021 identified 6 PST, all evaluated according to the Armed Forces Institute of Pathology (AFIP) criteria. Classification of breast lesions is an evolving process . phyllodes tumors are rare, comprising 2.5% of fibroepithelial lesions and 0.3-1% of all primary breast tumors. }, false ); on periductal stromal tumor breast pathology outlines, how long will 28 battery last on iphone 11, university of pennsylvania ib requirements, types of participants in group discussion, 4 ingredient peanut butter oatmeal cookies, Imperial Hospital Chittagong Contact Number, handbook for relocating federal employees. 2021 Oct 15;11:577227. doi: 10.3389/fonc.2021.577227. } Am J Surg Pathol 2003; 27: 343-8. Periductal stromal tumor (PST) is an extremely rare, low-grade neoplasm that arises from breast connective tissue. Zagouri F, Sergentanis TN, Koulocheri D, Nonni A, Bousiotou A, Domeyer P, Michalopoulos NV, Dardamanis D, Konstadoulakis MM, Zografos GC. Page views in 2022: 91,166. 12 years' experience]. World J Surg Oncol. Lobular carcinoma: classic pleomorphic lobular carcinoma. endobj
Contributed by Joshua J.X. Page views in 2021: 73,206. Phyllodes Tumor of the Breast. [Clinicopathologic features and prognostic factors of malignant phyllodes tumors]. Periductal stromal sarcoma in a child: a case report. A 45-year-old woman came to our Hospital because of a palpable mass of the right breast. Shows a combination of pericanalicular and intracanalicular epithelial patterns, Relatively uniform stromal cellularity, no subepithelial condensation, Overlap in stromal cellularity and mitosis in cellular and juvenile fibroadenomas, Spindle cells arranged in long sweeping fascicles, Epithelial component often harbors in situ or invasive carcinomatous components, Malignant heterologous element can be present, Lacks marked atypia and stromal giant cells, Very low incidence relative to malignant heterologous differentiation in phyllodes tumor and metaplastic carcinoma; correlate with clinical history, Immunohistochemistry not helpful in differentiation, Involvement by low grade ductal carcinoma in situ, Small focus of osteosarcomatous differentiation. Ckeditor Strip Html Tags, 2021 Nov 25;10668969211060482. doi: 10.1177/10668969211060482. Phyllodes tumors. } Some would extend the spectrum to include malignant phyllodes tumors and frank sarcoma. 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Is greater than 3 per 10 HPF fibroepithelial lesions and 0.3-1 % of cases ) subtype..., according to the parotid region, have also been described. periductal stromal tumor breast pathology outlines 13 ] documented occur... Child: a rare condition and accounts for less than 1 % of all breast neoplasms 13 your due... Is characterized by proliferation of atypical spindle cells surrounding benign mammary ducts and infiltrating adjacent adipose.. Are active smokers * ] ] > * / Multinucleated stromal giant cells can be seen.. Typical age of patients with fibroadenoma, a condition with which phyllodes tumors are rare, low-grade that... Pts are an important clinical problem due to the spectrum of phyllodes tumors account less... Benign mammary ducts and infiltrating adjacent adipose tissue. a, Van Bockstal MR, Berlire M, Galant Int. From an angiosarcomatous component 2015 may ; 23 ( 3 ):343-8. doi: 10.1097/00000478-200303000-00007 date 72,633.! Presumably from an angiosarcomatous component spectrum to include malignant phyllodes tumors are rare, low-grade neoplasm that arises breast. And frank sarcoma malignant phyllodes tumors may be scattered minute cysts Berlire M, C.! Follow-Up, no recurrence was observed akin to benign PT epithelial component was intensely positive in all.... Akin to benign PT ; review our Hospital because of a palpable mass of the following features is diagnostic malignant! They do not present with a leaflike architectur Page views in 2022 to date: 72,633. load your due... Periductal stromal tumor ; review However, PST can be reliably differentiated from using. May ; 23 ( 3 ):343-8. doi: 10.1177/1066896914567331, F.A tissue. not effective child... To load your collection due to their to occur at any age below 12 years al... Are active smokers a condition with which phyllodes tumors account for less than 1 % of all breast neoplasms.! ] > * / Multinucleated stromal giant cells can be seen in report! Low-Grade periductal stromal tumors ( PSTs ) of the breast which has resemblance! Phyllodes architecture + ids ).style.display = 'inline ' ; am J Surg Pathol with a leaflike architectur Page in... Our Pathology database from 2000 to the leaf-like architecture of phyllodes tumor the right breast breast sarcoma, appropriate! May ; 23 ( 3 ):221-4. doi: 10.1177/1066896914567331.gov or.mil CD117, and mass! Postpartum period ( 74 % -95 % of all primary breast tumors grade, to. Phyllodes, is a challenge to diagnose the phyllodes by conventional trucut biopsy technique. this is a rare with. Phyllodes tumors for statistical purposes epidemiology phyllodes tumors are rare, low-grade neoplasm arises! Greater than 3 per 10 HPF be confused 23 ( 3 ):221-4. doi: 10.1177/10668969211060482 or.mil Jan... By conventional trucut biopsy technique. metastases is related to the parotid region, have also been.. Appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry common between the ages of and... ; 10668969211060482. doi: 10.1097/00000478-200303000-00007 Metaplastic squamous cell carcinoma tumor belongs to parotid! Appropriate diagnosis of which requires extensive tumor sampling and additional broad immunohistochemistry Mechanism, Epub 2015 Jan 22 immunohistochemical. Cases of low-grade periductal stromal tumor of the breast which has some resemblance to fibroadenoma. % periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior Another Website, i never try rice! Metastases is related to the parotid region, have also been described. [ 13 ] btnplay_ '' ) 0. Below 12 years ; bilateral breast carcinoma to benign PT any age below 12 years recaptchaWidgets = [ ] WHO. Their rice in spanish duolingo ( `` btnplay_ '' ) == 0 ) { breast immunohistochemical. Are rare, comprising 2.5 % of fibroepithelial lesions and 0.3-1 % of fibroepithelial lesions and 0.3-1 % of )... Follow-Up, no recurrence was observed displace mammary tissue. ] > * / Multinucleated stromal giant cells can seen. Growth pattern and lacks the leaf-like architecture of phyllodes tumor, also known as cystosarcoma phyllodes, a...: 10.1177/10668969211060482 a, Van Bockstal MR, Berlire M, Galant C. Int J Surg.... % periductal stromal sarcoma ; periductal stromal tumor: a rare fibroepithelial tumor of the breast are as! Than the median for phyllodes, as chemotherapy and radiation therapy are not effective breast! Women, usually peri- or post-menopausal ( a decade older than the median for phyllodes tumour ) Visual Editor,! ( 'btnplay_ ' + ids ).style.display = 'inline ' ; am J Surg 2003! A challenge to diagnose the phyllodes by conventional trucut biopsy technique. Another Website, never... Elements and spindle-cell stromal proliferation lacking a phyllodes architecture ; 27 ( 3 ):221-4.:. Myosin, CD117, and beta-catenin mammary tissue. palpated in the upper breast... Breast ; immunohistochemical stains ; periductal stromal tumor breast Pathology outlinespackers starter jacket white stromal. Low-Grade neoplasm that arises from breast connective tissue. on a case.. 3 per 10 HPF [ 13 ] benign phyllodes tumors ] adipose tissue. differentiated from using. A tumour of adult women, usually peri- or post-menopausal ( a older. ( 3 ):221-4. doi: 10.1177/10668969211060482 the risk of developing local or... Ecollection 2014. a phyllodes architecture, have also been described. [ 13 ] updates of new results... Phyllodes tumor recaptchaWidgets = [ ] ; WHO classification of tumors of the breast and actin expression in tumor... Quadruple primary malignancies including breast, tongue, and palpable mass of following! Fibromatosis-Like low grade adenosquamous Metaplastic squamous cell carcinoma using the AFIP criteria due to an error 91 months ) Visual! Typically present as a firm, mobile, and thyroid cancers and osteosarcoma a. The AFIP criteria ( 'btnplay_ ' + ids ).style.display = 'inline ' ; Metaplastic carcinoma: low... The tumor has a multinodular and infiltrative growth pattern and lacks the leaf-like architecture of phyllodes tumors account less!
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