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目的:探讨乳头浸润性汗管瘤样腺瘤的临床病理学特征。方法:对1例与乳腺浸润性导管癌并发的乳头浸润性汗管瘤样腺瘤进行临床病理和免疫组织化学分析,并结合文献讨论其诊断与鉴别诊断。结果:肿瘤位于乳头部皮下纤维结缔组织内,由形态温和的上皮细胞排列呈小管、少数呈条索和巢状,并向周围间质内浸润。部分小管呈“逗点/蝌蚪”状并形成角化囊肿。免疫组织化学染色显示:小管内衬细胞表达细胞角蛋白(cytokeratin,CK),CK5/6,小管CAM5.2阳性,小管细胞不表达雌激素受体,孕激素受体,CerbB2,CK8/18,P53和囊泡病液体蛋白15;小管外层细胞呈P63和平滑肌肌动蛋白散在阳性;Ki67约1%。结论:乳头浸润性汗管瘤样腺瘤是一种易与乳腺恶性肿瘤相混淆的罕见良性肿瘤,了解其临床病理特征可避免误诊及过度治疗。
Objective: To investigate the clinicopathological features of tubal invasive ductal adenoma. Methods: One case with invasive ductal adenocarcinoma of the papillary duodenal tuberculous adenoma was analyzed by clinicopathological and immunohistochemical methods, and its diagnosis and differential diagnosis were discussed in combination with the literature. Results: The tumor was located in the subcutaneous fibrous connective tissue of the papilla. The epithelial cells in the shape of the tumor were arranged in small tubules. A few of them showed cords and nests and infiltrated into the surrounding interstitium. Some of the tubules were “comma / tadpole” -like and formed keratocysts. Immunohistochemical staining showed that cytokeratin (CK), cytokeratin (CK), cytokeratin (CK5 / 6), tubular CAM5.2 were positive in tubule lining cells, estrogen receptor, progesterone receptor, CerbB2, CK8 / P53 and vesicular disease fluid protein 15; small outer tube cells P63 and smooth muscle actin scattered positive; Ki67 about 1%. Conclusions: Papillary tuberculoma-like adenoma is a rare benign tumor that is easily confused with malignant breast cancer. To understand its clinicopathological features can avoid misdiagnosis and over-treatment.