乳腺恶性分叶状肿瘤的临床病理学观察  

Malignant phyllode tumors of the breast:A chinical pathological study

作　　者：宋红杰[1] 季育娟 

机构地区：[1]江苏省海门市人民医院病理科,江苏海门226100

出　　处：《现代肿瘤医学》2009年第12期2307-2309,共3页Journal of Modern Oncology

摘　　要：目的:探讨乳腺恶性分叶状肿瘤的临床病理特征、免疫组织化学特征、诊断及鉴别诊断、预后。方法:对6例乳腺恶性分叶状肿瘤进行病理组织学观察和免疫组织化学标记,并随访10-84个月。结果:乳腺恶性分叶状肿瘤病史上均有较长时间或数年前相对静止的无痛性肿块。大体结构呈分叶状膨胀性生长、包膜不完整或无包膜;镜下肿瘤组织由间叶细胞构成,细胞异型性大,主要呈纤维肉瘤、恶性纤维组织细胞瘤形态,部分肿瘤组织向脂肪肉瘤、平滑肌肉瘤、及横纹肌肉瘤方向分化。肿瘤组织可以经淋巴道转移。肿瘤细胞免疫组织化学表达情况:Vim:6/6、AE1/AE3:0/6、EMA:0/6、CD117:3/6、CD34:1/6、S-100:2/6、SMA:2/6、CD99:4/6、bcl-2:3/6、p53:5/6、Ki67:>10%、ER:0/6、PR:2/6、MyoD1:1/6。结论:乳腺恶性分叶状肿瘤病理诊断主要依据组织学观察,免疫组织化学检测有一定的辅助作用。预后主要由肿瘤组织分化程度决定。Objective：To investigate the chinical pathological and immunohistochemical characteristics of malignant phyUode tumor（MFF） of the breast,and to explore the diagnosis criteria and prognosis. Methods： Six specimens with MPTs of the breast were observed under light microscope with stains of hematoxylin eosin and immunohisto- chemical staining. The first antibodies included Vim, AE1/AE3, EMA, CD117, CD34, S - 100, SMA, CD99, bcl - 2, p53, Ki67, ER, PR, MyoD1 were tested. Results ： the MPTs had a long period of relative rest in medical history. All of 6 cases with MPTs presented the well - circumscribed masses had leaf - like structures. The MPTs were made of overgrowing and malignant mesenchymal cells with big heteromorphism, most of them were differentiated to fibrosarcoma and malignant fibrous histiocytoma, part of them were differentiated to liposarcoma, leiomyosarcoma and rhabdomyosarcoma. The stromal component was postive for Vim 6/6,AE1/AE3 0/6,EMA 0/6, CD117 3/6, CD34 1/6,S - 100 2/ 6, SMA 2/6, CD99 4/6,bcl - 2 3/6, p53 5/6, Ki67 〉 10%, ER 0/6, PR 2/6, MyoD1 1/6, and the others were negative. Conclusion： The diagnosis of MPTs depends mainly on the histological features of the tumor. The immunohistochemical expression in MPTs is helpful to the diagnosis. The prognosis depends on the differentiation of MPTs.

关 键 词：乳腺 恶性分叶状肿瘤 临床病理 免疫组化 

分 类 号：R737.9[医药卫生—肿瘤]