中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2011年
7期
471-474
,共4页
乳腺肿瘤%免疫表型分型%病理学,临床
乳腺腫瘤%免疫錶型分型%病理學,臨床
유선종류%면역표형분형%병이학,림상
Breast neoplasms%Immunophenotyping%Pathology,clinical
目的 探讨乳腺起源于微腺体腺病的浸润性癌(MGACA)的临床病理学特征、免疫表型、诊断和鉴别诊断.方法 收集3例MGACA患者的临床和病理资料,对标本进行病理形态学观察,免疫组织化学(EnVision)染色[CK7、S-100蛋白、雌激素受体(ER)、孕激素受体(PR)、HER2、平滑肌肌动蛋白(SMA)、肌特异性肌动蛋白(MSA)、p63]和PAS特殊染色,并复习文献.结果 (1)形态学:3例MGACA标本均观察到不同阶段形态的连续发展过程:从微腺体腺病到不典型微腺体腺病,到导管原位癌,到浸润性癌.例1的浸润性癌成分为浸润性导管癌,例2和例3的浸润性癌成分部分区域为浸润性导管癌,部分区域为产生基质的癌.(2)免疫组织化学和特殊染色:3例MGACA中不同病变区域的所有上皮细胞均呈现CK7和S-100蛋白阳性,ER和HER2阴性.例1和例2 PR阴性,例3 PR弱阳性.SMA、MSA和p63染色显示所有病变区域腺体周围均无肌上皮围绕.PAS染色显示在微腺体腺病、不典型微腺体腺病和导管原位癌区域腺体周围有完整的基底膜围绕,而在浸润性癌区域上皮周围基底膜消失.结论 MGACA是一类少见的乳腺肿瘤,具有独特的形态学和免疫表型特征,其生物学行为有待进一步研究.
目的 探討乳腺起源于微腺體腺病的浸潤性癌(MGACA)的臨床病理學特徵、免疫錶型、診斷和鑒彆診斷.方法 收集3例MGACA患者的臨床和病理資料,對標本進行病理形態學觀察,免疫組織化學(EnVision)染色[CK7、S-100蛋白、雌激素受體(ER)、孕激素受體(PR)、HER2、平滑肌肌動蛋白(SMA)、肌特異性肌動蛋白(MSA)、p63]和PAS特殊染色,併複習文獻.結果 (1)形態學:3例MGACA標本均觀察到不同階段形態的連續髮展過程:從微腺體腺病到不典型微腺體腺病,到導管原位癌,到浸潤性癌.例1的浸潤性癌成分為浸潤性導管癌,例2和例3的浸潤性癌成分部分區域為浸潤性導管癌,部分區域為產生基質的癌.(2)免疫組織化學和特殊染色:3例MGACA中不同病變區域的所有上皮細胞均呈現CK7和S-100蛋白暘性,ER和HER2陰性.例1和例2 PR陰性,例3 PR弱暘性.SMA、MSA和p63染色顯示所有病變區域腺體週圍均無肌上皮圍繞.PAS染色顯示在微腺體腺病、不典型微腺體腺病和導管原位癌區域腺體週圍有完整的基底膜圍繞,而在浸潤性癌區域上皮週圍基底膜消失.結論 MGACA是一類少見的乳腺腫瘤,具有獨特的形態學和免疫錶型特徵,其生物學行為有待進一步研究.
목적 탐토유선기원우미선체선병적침윤성암(MGACA)적림상병이학특정、면역표형、진단화감별진단.방법 수집3례MGACA환자적림상화병리자료,대표본진행병리형태학관찰,면역조직화학(EnVision)염색[CK7、S-100단백、자격소수체(ER)、잉격소수체(PR)、HER2、평활기기동단백(SMA)、기특이성기동단백(MSA)、p63]화PAS특수염색,병복습문헌.결과 (1)형태학:3례MGACA표본균관찰도불동계단형태적련속발전과정:종미선체선병도불전형미선체선병,도도관원위암,도침윤성암.례1적침윤성암성분위침윤성도관암,례2화례3적침윤성암성분부분구역위침윤성도관암,부분구역위산생기질적암.(2)면역조직화학화특수염색:3례MGACA중불동병변구역적소유상피세포균정현CK7화S-100단백양성,ER화HER2음성.례1화례2 PR음성,례3 PR약양성.SMA、MSA화p63염색현시소유병변구역선체주위균무기상피위요.PAS염색현시재미선체선병、불전형미선체선병화도관원위암구역선체주위유완정적기저막위요,이재침윤성암구역상피주위기저막소실.결론 MGACA시일류소견적유선종류,구유독특적형태학화면역표형특정,기생물학행위유대진일보연구.
Objective To study the clinicopathologic features, immunophenotypes and differential diagnoses of invasive carcinoma arising in breast microglandular adenosis (MGACA). Methods Clinical and pathologic findings of 3 cases of MGACA were analyzed by histomorphology and immunohistochemical staining of CK7, S-100 protein, ER, PR, HER2, SMA, MSA, p63 and PAS. Literatures were reviewed. Results (1) Histologically, 3 tumors all showed a spectrum of glandular proliferations ranging from microglandular adenosis (MGA) to atypical microglandular adenosis (AMGA) to in situ carcinoma (DCIS) to invasive carcinoma. The invasive carcinoma component was ductal in case 1, and matrix-producing in case 2 and case 3. (2) All epithelial cells in MGA, AMGA, DCIS and MGACA were positive for CK7 and S-100 protein, but were negative for ER and HER2. PR was negative in case 1 and case 2 but was low positive in case 3. Myoepithelial cell differentiation was not demonstrated in MGA, AMGA, DCIS and MGACA by immunohistochemical staining for SMA, MSA or p63. PAS staining showed the presence of basement membrane in MGA, AMGA and DCIS, except MGACA. Conclusions MGACA is an extremely rare tumor of the breast and has distinct morphological and immunohistochemical features. Further studies are needed to evaluate the clinical behavior of this rare neoplasm.
