临床与病理杂志
臨床與病理雜誌
림상여병리잡지
International Journal of Pathology and Clinical Medicine
2015年
8期
1595-1598
,共4页
非典型大汗腺增生%乳腺%诊断%鉴别诊断
非典型大汗腺增生%乳腺%診斷%鑒彆診斷
비전형대한선증생%유선%진단%감별진단
atypical apocrine metaplasia%breast%diagnosis%diferential diagnosis
目的：探讨乳腺硬化性腺病伴非典型大汗腺增生临床病理特征、诊断及鉴别诊断。方法：收集1例乳腺硬化性腺病伴非典型大汗腺增生的病例的临床与病理资料，分析其临床表现，组织学特征和免疫组化特征，并复习文献。结果：肿物位于左乳3点钟位，直径约1.7 cm，肿物质硬，边界欠清。光镜下可见肿物由多个大小不一类圆型结节构成，结节之间见硬化的纤维性间质，>90%区域由大汗腺化生的细胞构成，排列呈圆形或不规则腺样、实性小巢状，腺腔内有少量粉红染的分泌物。大汗腺化生的细胞形状不规则，有丰富的颗粒状嗜酸性胞浆，小部分细胞胞质淡染透明呈泡沫颗粒状，可有空泡形成；细胞核增大，大小不一，圆形或轻度不规则，核膜增厚，有1至2个大而突出的嗜酸性核仁，部分细胞可见核仁周空晕，核分裂2/50HPF。免疫组化示，CK、EMA、GCDFP-15阳性，Ki6710%阳性，S-100、ER、PR、HER-2阴性，calponin和P63示增生的腺体周围有肌上皮存在。结论：乳腺硬化性腺病伴非典型大汗腺增生是一种罕见的乳腺病变，组织学形态特征是其主要诊断依据，需要与低级别大汗腺导管原位癌与浸润性大汗癌进行鉴别。
目的：探討乳腺硬化性腺病伴非典型大汗腺增生臨床病理特徵、診斷及鑒彆診斷。方法：收集1例乳腺硬化性腺病伴非典型大汗腺增生的病例的臨床與病理資料，分析其臨床錶現，組織學特徵和免疫組化特徵，併複習文獻。結果：腫物位于左乳3點鐘位，直徑約1.7 cm，腫物質硬，邊界欠清。光鏡下可見腫物由多箇大小不一類圓型結節構成，結節之間見硬化的纖維性間質，>90%區域由大汗腺化生的細胞構成，排列呈圓形或不規則腺樣、實性小巢狀，腺腔內有少量粉紅染的分泌物。大汗腺化生的細胞形狀不規則，有豐富的顆粒狀嗜痠性胞漿，小部分細胞胞質淡染透明呈泡沫顆粒狀，可有空泡形成；細胞覈增大，大小不一，圓形或輕度不規則，覈膜增厚，有1至2箇大而突齣的嗜痠性覈仁，部分細胞可見覈仁週空暈，覈分裂2/50HPF。免疫組化示，CK、EMA、GCDFP-15暘性，Ki6710%暘性，S-100、ER、PR、HER-2陰性，calponin和P63示增生的腺體週圍有肌上皮存在。結論：乳腺硬化性腺病伴非典型大汗腺增生是一種罕見的乳腺病變，組織學形態特徵是其主要診斷依據，需要與低級彆大汗腺導管原位癌與浸潤性大汗癌進行鑒彆。
목적：탐토유선경화성선병반비전형대한선증생림상병리특정、진단급감별진단。방법：수집1례유선경화성선병반비전형대한선증생적병례적림상여병리자료，분석기림상표현，조직학특정화면역조화특정，병복습문헌。결과：종물위우좌유3점종위，직경약1.7 cm，종물질경，변계흠청。광경하가견종물유다개대소불일류원형결절구성，결절지간견경화적섬유성간질，>90%구역유대한선화생적세포구성，배렬정원형혹불규칙선양、실성소소상，선강내유소량분홍염적분비물。대한선화생적세포형상불규칙，유봉부적과립상기산성포장，소부분세포포질담염투명정포말과립상，가유공포형성；세포핵증대，대소불일，원형혹경도불규칙，핵막증후，유1지2개대이돌출적기산성핵인，부분세포가견핵인주공훈，핵분렬2/50HPF。면역조화시，CK、EMA、GCDFP-15양성，Ki6710%양성，S-100、ER、PR、HER-2음성，calponin화P63시증생적선체주위유기상피존재。결론：유선경화성선병반비전형대한선증생시일충한견적유선병변，조직학형태특정시기주요진단의거，수요여저급별대한선도관원위암여침윤성대한암진행감별。
Objective:To investigate the clinicpathological features of atypical apocrine metaplasia in sclerosin adenosis of the breast.Methods: 1 case of atypical apocrine metaplasia in sclerosin adenosis of the breast was investigated, included clinical and pathological data, and analyzed their clinical manifestations, histological and immunohistochemistical features, and reviewed the literature.Results: hTere was a round hard mass located at 3 o’clock in the left breast, diameter about 1.7 cm. Multiple unequal round nodules were shown with sclerosis fibrous stroma. Atypical apocrine metaplasia cells occupied the region of >90%, cells arrangemented round or irregular glandular or the small nest, and the pink secretion in glandular cavity. The sharp of atypical apocrine metaplasia cells was irregular, with abundant granular eosinophilic cytoplasm, the nuclei was enlarged, round or <br> slightly irregular, with thickening nuclear membrance. Most cells had 1 to 2 a large and prominent eosinophilic acid nucleolus. hTe mitosis was rare (2/50HPF). Atypical apocrine metaplasia cells were positive for CK, EMA, GCDFP-15, Ki67 index was 10%, negative for S-100, ER, PR, and HER2. Calponin and p63 showed myoepithelial cells around the gland.Conclusion: Atypical apocrine metaplasia in sclerosin adenosis is an uncommon breast lesion, identiifed with low-level apocrine ductal carcinoma in situ and invasive apocrine carcinoma by histological and immunohistochemistical characteristics.
