乳腺纤维瘤病样梭形细胞癌临床病理分析  

Fibromatosis-like spindle cell carcinoma of the breast:clinicopathological analysis of 3 cases and review of the literature

作　　者：张秀珊[1] 严军宁[1] 张玉兰[1] 章德灴 王健[1] 

机构地区：[1]合肥市第一人民医院病理科,合肥230061

出　　处：《临床与实验病理学杂志》2005年第5期559-562,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨乳腺纤维瘤病样梭形细胞癌(fibrom atosis-like sp ind le cell carc inom a,FLSCC)临床病理特征。方法对3例FLSCC病例进行光镜观察和免疫组化染色〔CK、CK(34βE12)、vim entin、SMA、ER、PR、K i-67、c-erbB-2〕。结果3例均为女性,年龄分别为47、53、56岁,均可触及乳腺肿块。肿瘤境界清楚,但镜下边缘呈浸润性。肿瘤主要是梭形细胞、多边形细胞、少量的管状腺体及鳞上皮巢混合,间质纤维明显增生伴胶原化,细胞成束状排列或散在分布,似纤维瘤病样改变。梭形细胞分化良好,异型性不明显,部分区域细胞较丰富,其间聚集的上皮簇或片状多边形细胞核有轻度异型,可见少数核分裂象。多边形细胞与梭形细胞有移行。病变中亦可见淋巴细胞、浆细胞聚集浸润。上皮细胞、多边形细胞及部分梭形细胞CK(34βE12)、CK(AE1/AE3)阳性,CK阴性的梭形细胞表达vim entin、SMA。3例均行肿块切除,其中1例,术后4个月复发,再行乳腺根治术。结论乳腺(纤维瘤病样)梭形细胞癌是一种少见的、低度恶性肿瘤,诊断需依赖免疫组化标记并与乳腺其它梭形细胞肿瘤相鉴别。Purpose To study the clinical pathological features, diagnosis and differential diagnosis of spindle cell carcinoma of the breast. Methods Three cases of spindle cell carcinomas were studied using HE and immunohistochemical staining. Results All three cases occurred in women, the age ranged from 47 to 56. All patients presented with palpable tumors. The tumors showed a fibromatosis- like proliferation of spindle cells and epithelial polygonal cells with prominent collagenization of stroma, and infiltrating of surrounding adipose tissues. Both epithelial cells and part spindle cell expressed CK. The spindle cells was positive for vimentin, SMA was confined to the cytokeratin-negative cell. Three cases were treated with local excision, one of cases developed local recurrence after excision. Conclusions（Fibromatosis-like） Spindle cell carcinoma may be rare, low grade tumor in the breast. The diagnosis mainly relies on immunohistochemical findings and should be differentiated from both neoplastic and nonneoplsistic spindle cell lesions of the breast.

关 键 词：乳腺肿瘤 梭形细胞癌 诊断 鉴别 

分 类 号：R737.9[医药卫生—肿瘤] R730.26[医药卫生—临床医学]