乳腺皮脂腺样癌临床病理诊断  

Clinicopathologic diagnosis of sebaceous gland-like carcinoma of the breast

作　　者：陈健[1] 郭瑞峰[1] 梁化印[1] 杜双存[2] 田茹[1] 董红梅[1] 

机构地区：[1]解放军252医院病理科,河北保定071000 [2]解放军261医院病理科,北京100094

出　　处：《临床与实验病理学杂志》2005年第3期273-276,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨乳腺皮脂腺样癌的临床病理学特征及其诊断和鉴别诊断要点。方法对1例乳腺皮脂腺样癌进行光镜观察和免疫组化标记。结果癌组织由两型细胞构成:一型为未分化细胞,较基底细胞胞质丰富;另一型为较分化细胞,胞界清楚,胞体宽大,胞质丰富,有小空泡,两型细胞均可见1～3个小红核仁。癌细胞排列成不规则小叶,各小叶中两型细胞的数目和分布不一,部分似皮脂腺小叶结构。可见癌组织与残存小叶内导管上皮移行结构,部分区域伴鳞化。结论皮脂腺样癌为罕见的特殊类型乳腺癌,可能源自小叶内导管上皮皮脂腺化生。确诊须符合下列标准:①肿物位于乳腺实质内;②具备皮脂腺分化特点及恶性特征;③可见癌组织与乳腺导管上皮移行结构。Purpose To study the clinicopathological features,diagnosis and differential diagnosis of sebaceous gland-like carcinoma of the breast. Methods One case of sebaceous gland-like carcinoma of the breast was studied microscopically and immunohistochemically. Results The tumor was composed of two type cells arranged in irregular lobules,one was undifferentiated,containing more cytoplasm than basal cell,the other was differentiated cell,characterized by clear cell with boundary,abundant cytoplasm and small vacuole. Both cells had 1 to 3 red small nucleoli in one nucleus. Sebaceous gland-like lobules were present in some areas. Transformation of residual duct epithelial cells to neoplastic cells were seen in some breast lobule. Squamous epithelia metaplasia was seen in some areas. Conclusions Sebaceous gland-like carcinoma is a rare special type of the breast carcinomas,it may originate from sebaceous gland metaplasia of duct epithelia in breast lobule. For diagnosis,following criteria must be satisfied: the tumor locates in the breast; The tumor differentiates to sebaceous gland and has malignant features; The duct epithelia transform to neoplastic cells.

关 键 词：临床病理诊断 样癌 临床病理学特征 特殊类型乳腺癌 免疫组化标记 上皮移行 未分化细胞 皮脂腺分化 癌组织 诊断要点 光镜观察 细胞构成 基底细胞 细胞排列 乳腺导管 内导管 小叶 可见 不规则 结构 胞质 

分 类 号：R36-4[医药卫生—病理学] R736.1[医药卫生—基础医学]