论文部分内容阅读
目的探讨乳腺分泌型癌的临床病理学特征。方法对1例乳腺分泌型癌的临床资料、病理形态学、免疫组织化学及特殊染色进行观察,并通过复习相关文献进行分析。结果乳腺无痛性肿物10余年伴刺痛2周,术中所见肿物质地中等偏硬,边界欠清,活动度差,包膜不完整。显微镜下肿瘤细胞排列成囊泡状、筛孔状,腔内充满嗜酸性分泌物,酷似甲状腺滤泡,部分区呈实性巢团状,小管状及乳头状结构,被覆细胞常空泡状;肿瘤细胞异型性不明显,核分裂像少见,罕见病理性核分裂像。免疫组化:ER、PR、HER-2均(-),Ki-67(5%+),癌细胞表达CKH、CK8/18、S-100、E-cadherin、P120(膜+)、GCDFP-15,不表达肌上皮标记calponin、p63及SMA。特殊染色:肿瘤细胞内外、囊腔及小管腔内见AB-PAS染色阳性的分泌物。结论乳腺分泌型癌是一种罕见且预后较好的肿瘤,该肿瘤组织形态特殊,属于特殊类型乳腺癌,临床病史及影像学检查很容易误诊为乳腺良性肿瘤。
Objective To investigate the clinicopathological features of breast cancer. Methods The clinical data, histopathology, immunohistochemistry and special staining of one case of breast cancer were observed and analyzed by reviewing relevant literature. Results painless tumor of the breast more than 10 years with stinging for 2 weeks, intraoperative findings of the material medium hard, border less clear, poor activity, incomplete capsule. Microscopic tumor cells arranged in a vesicular, mesh-like cavity filled with eosinophilic secretions, resembles thyroid follicles, some areas were solid nest mass, tubular and papillary structure, often empty vacuoles; Tumor cell atypia is not obvious, as rare as mitotic, rare pathological mitosis. The expression of CKH, CK8 / 18, S-100, E-cadherin, P120 (membrane +), GCDFP- 15, do not express myoepithelial markers calponin, p63 and SMA. Special staining: inside and outside the tumor cells, cysts and small lumen see AB-PAS staining positive secretions. Conclusions Breast-secreting carcinoma is a rare and well-prognined tumor. The tumor has a special morphology and belongs to a special type of breast cancer. Clinical history and imaging examination are easily misdiagnosed as benign breast tumors.