中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2011年
10期
1794-1796
,共3页
乳腺肿瘤%前驱病变%不典型增生%导管原位癌%病理形态学
乳腺腫瘤%前驅病變%不典型增生%導管原位癌%病理形態學
유선종류%전구병변%불전형증생%도관원위암%병리형태학
Breast neoplasia%Precursor lesion%Atypical ductal hyperplasia%Ductal carcinoma in situ%Pathology
目的 探讨乳腺浸润性导管癌前驱病变的诊断及鉴别诊断要点.方法 收集乳腺癌前驱病变86例,光镜下观察苏木素-伊红(HE)切片,将病变分为:导管上皮不典型增生(ADH)组,导管原位癌(DCIS)组,包括低、中度、高度DCIS,并观察ADH和DCIS的细胞特征及形态结构.结果 ADH组35例,18例显示在普通型导管增生(UDH)的背景上混杂有非典型细胞或特征性结构；另17例与低度DCIS有相似的结构和细胞学特征.DCIS组51例,低度者(17例)细胞结构单一,界限清楚,大小、形态一致,异型性不明显,无坏死及核分裂像；中高度者(分别为14例和20例)细胞极性消失,异型性明显,中度为灶状坏死,高度为大片粉刺样坏死；结构上有实体型、筛状型、粉刺型及混合型.结论 ADH与DCIS的诊断主要依赖细胞和结构特征；部分ADH虽与低度DCIS相似,但仍有差异.
目的 探討乳腺浸潤性導管癌前驅病變的診斷及鑒彆診斷要點.方法 收集乳腺癌前驅病變86例,光鏡下觀察囌木素-伊紅(HE)切片,將病變分為:導管上皮不典型增生(ADH)組,導管原位癌(DCIS)組,包括低、中度、高度DCIS,併觀察ADH和DCIS的細胞特徵及形態結構.結果 ADH組35例,18例顯示在普通型導管增生(UDH)的揹景上混雜有非典型細胞或特徵性結構；另17例與低度DCIS有相似的結構和細胞學特徵.DCIS組51例,低度者(17例)細胞結構單一,界限清楚,大小、形態一緻,異型性不明顯,無壞死及覈分裂像；中高度者(分彆為14例和20例)細胞極性消失,異型性明顯,中度為竈狀壞死,高度為大片粉刺樣壞死；結構上有實體型、篩狀型、粉刺型及混閤型.結論 ADH與DCIS的診斷主要依賴細胞和結構特徵；部分ADH雖與低度DCIS相似,但仍有差異.
목적 탐토유선침윤성도관암전구병변적진단급감별진단요점.방법 수집유선암전구병변86례,광경하관찰소목소-이홍(HE)절편,장병변분위:도관상피불전형증생(ADH)조,도관원위암(DCIS)조,포괄저、중도、고도DCIS,병관찰ADH화DCIS적세포특정급형태결구.결과 ADH조35례,18례현시재보통형도관증생(UDH)적배경상혼잡유비전형세포혹특정성결구；령17례여저도DCIS유상사적결구화세포학특정.DCIS조51례,저도자(17례)세포결구단일,계한청초,대소、형태일치,이형성불명현,무배사급핵분렬상；중고도자(분별위14례화20례)세포겁성소실,이형성명현,중도위조상배사,고도위대편분자양배사；결구상유실체형、사상형、분자형급혼합형.결론 ADH여DCIS적진단주요의뢰세포화결구특정；부분ADH수여저도DCIS상사,단잉유차이.
Objective To study the differential diagnosis of the precursor lesions of the breast carcinoma.Methods Eighty-six cases of the precursor lesions of the breast carcinoma were involved.Hematoxylin and Eosin (HE) sections were observed by microscope.The lesions were re-divided into atypical ductal hyperplasia ( ADH,n =35 ) and ductal carcinoma in situ ( DCIS,n =51 ) groups,and their cytological and architectural features were observed.Results In ADH group,18 cases displayed the architectural features of UDH and showed an admixture of dusters of atypical cells within areas of UDH,and the remaining 17 cases displayed both cytological and architectural features similar to low-grade DCIS.In DCIS group,17 cases of low-grade DCIS were composed of small and monomophic cells.The nuclei had the uniform size and a regular chromatin pattern with inconspicuous nucleoli.Mitotic figures were rare.Forteen cases of intermediate-grade DCIS had atypical cells with nucleoli and coarse chromatin.Some ducts contained intraluminal necrosis.High-grade DCIS was composed of highly atypical cells.Nuclei were pleomorphic and hyperchromatin,and had prominent nucleoli.Mitotic figures and comedo necrosis were common.They could be divided into solid,cribriform,comedo,and mixture patterns.Conclusion Diagnosis of ADH and DCIS mainly relied on their cytological and architectural features.There were slight difference between some ADH and low-grade DCIS although they were very similar.
