CAJ | 학술논문

目的探讨乳腺囊内乳头状癌的临床病理特征及其鉴别诊断.方法观察14例囊内乳头状癌的临床病理特点,并采用平滑肌肌动蛋白(SMA)、肌特异性肌动蛋白(MSA)、ER、PR、p63、广谱和高相对分子质量CK(AE1/AE3和34βE12)和CK5/6进行EnVision法染色.结果 14例发病年龄42～79岁,平均65.4岁.乳腺肿块是最常见的症状.镜下见两种形态,以较纤细的乳头状结构为主,乳头纤维血管轴心衬覆高柱状上皮细胞,无肌上皮细胞(9例)和以张力高的筛孔或实性结构为主,其问仍可见纤维血管轴心(5例);11例为单纯性囊内乳头状癌,1例伴有导管原位癌,2例伴有浸润性癌.肿瘤细胞核为低级别,肿瘤细胞呈ER和PR弥漫强阳性,CK5/6和34βE12阴性或局灶弱阳性.肿瘤内未见肌上皮细胞,而肿瘤外围肌上皮消失或仅散在着色.结论囊内乳头状癌是一种发生在老年妇女的少见肿瘤,在临床表现、组织形态和免疫表型上的独特性有助于鉴别诊断.
목적 탐토유선낭내유두상암적림상병리특정급기감별진단.방법 관찰14례낭내유두상암적림상병리특점,병채용평활기기동단백(SMA)、기특이성기동단백(MSA)、ER、PR、p63、엄보화고상대분자질량CK(AE1/AE3화34βE12)화CK5/6진행EnVision법염색.결과 14례발병년령42～79세,평균65.4세.유선종괴시최상견적증상.경하견량충형태,이교섬세적유두상결구위주,유두섬유혈관축심츤복고주상상피세포,무기상피세포(9례)화이장력고적사공혹실성결구위주,기문잉가견섬유혈관축심(5례);11례위단순성낭내유두상암,1례반유도관원위암,2례반유침윤성암.종류세포핵위저급별,종류세포정ER화PR미만강양성,CK5/6화34βE12음성혹국조약양성.종류내미견기상피세포,이종류외위기상피소실혹부산재착색.결론 낭내유두상암시일충발생재노년부녀적소견종류,재림상표현、조직형태화면역표형상적독특성유조우감별진단.
Objective To elucidate the clinicopathologic features,immunophenotype and differential diagnosis of intracystic papillary carcinoma(IPC).Methods The clinical and pathological characteristics of 14 cases of breast IPC were studied.Immunohistochemical study of SMA,MSA,ER,PR,p63,AE1/AE3,34βE12 and CK5/6 was performed using Envision method.Results The age of IPC patients ranged from 42 to 79.with a mean age of 65.4 years.A palpable mass was the most common symptom.There were two morphological features:(1)Slender papillae lined by tall columnar epithelial cells which were present directly on the fibrovascular cores without an intervening myoepithelial cell layer (9 cases).(2)The proliferation may assume a cribriform architecture with rigid,punched-out regular spaces or a solid glandular pattern,studded with fibrovascular cores(5 cases).Low nuclear grade is typically seen.Among the 14 cases of IPC,11 were of pure type.Ductal carcinoma in situ(DCIS)in adjacent ducts Was found in one case,and invasive carcinoma was found in two cases.Immunohistochemical results showed that the tumor cells were homogenously strongly positive for ER and PR,but were negative or focally and weakly positive for CK5/6 and 34βE12.Myoepithelial cell staining was negative within the tumor;and was diminished or scattered at the periphery of the tumor.Conclusions IPC is a rare entity that usually arises in older women.It is specific enough in its clinical presentation and morphologie appearance to warrant distinction from other breast lesions.