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探讨乳腺低度恶性导管周间质肉瘤的临床病理特点。方法通过HE及免疫组化染色对1例罕见的低级别导管周间质肉瘤进行临床病理观察。结果乳腺导管周间质肉瘤(低度恶性)具有独特的镜下特点:肿瘤由梭形肉瘤样细胞围绕开放的腺管和导管增生形成“袖套样”结构,无叶状结构;纤维或纤维脂肪组织将病变分隔成多个结节;病变浸润周围乳腺组织;可见骨化灶。免疫表型:肿瘤细胞vimentin弥漫强(+),CD99和bcl-2(+),SMA和CD34灶状(+),CD10及p53仅个别瘤细胞(+),Ki-67阳性率80%,广谱CK、EMA、ER、PR、S-100、CD117和desmin、p16均为(-)。该病例行乳腺改良根治术,无其他辅助治疗,随访无复发。结论导管周间质肉瘤是一种低度恶性肿瘤,首选治疗方式为手术切除,术中保证足够的正常乳腺组织切缘以避免复发。因治疗方式不同,需要与其他乳腺梭形细胞肿瘤相鉴别。
To investigate the clinicopathological features of low grade malignant ductal sarcoma of the breast. Methods One case of rare low-grade ductal sarcoma was examined by HE and immunohistochemistry. RESULTS: Mammary ductal interstitial sarcoma (low grade) had a unique microscopic appearance: the tumor formed a “sleeve-like” structure surrounded by open duct and ductal hyperplasia and had no leaflet structure; Or fibrous adipose tissue lesions will be divided into multiple nodules; lesions infiltrating the surrounding breast tissue; visible ossification. The immunophenotypes were diffuse (+), CD99 and bcl-2 (+), SMA and CD34 (+), CD10 and p53 only in some tumor cells (+), Ki-67 positive rate was 80% The broad-spectrum CK, EMA, ER, PR, S-100, CD117 and desmin, p16 were all (-). The case of modified radical mastectomy, no other adjuvant therapy, no recurrence. Conclusion Ductal steatosis is a low grade malignant tumor. The first choice of treatment is surgical excision, which ensures sufficient recurrence of normal breast tissue during operation. Due to different treatment methods, need to differentiate from other breast spindle cell tumors.