乳腺原发性腺泡细胞癌临床病理观察  

Clinicopathologic features of primary acinic cell carcinoma in breast

作　　者：张和平 解正新 曹登峰[2,3] 武莹[2,3] 李忠武[2,3] 

机构地区：[1]安徽省妇幼保健院病理科,合肥230001 [2]北京大学肿瘤医院 [3]北京市肿瘤防治研究所病理科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《诊断病理学杂志》2014年第2期76-79,共4页Chinese Journal of Diagnostic Pathology

基　　金：北京市科技新星计划(2010B033)

摘　　要：目的探讨乳腺原发性腺泡细胞癌(ACCA)的临床病理学特点、免疫表型、特殊染色特征及鉴别诊断。方法对1例乳腺原发性腺泡细胞癌进行分析,观察其组织学、免疫组化及特殊染色特征,并复习相关文献,探讨其临床病理学特征及预后。结果癌组织由2种细胞构成,一种为大的多边形腺泡样细胞,实性片状排列,细胞界限清楚,胞质丰富呈粗颗粒状,嗜双色性,核呈圆形或卵圆形,染色质稍粗糙,核仁不明显或伴有单个小核仁;另一种为小的闰管样细胞,胞质嗜酸性、细颗粒状,核圆形,核仁不明显或伴单个小核仁;腺泡样细胞和闰管样细胞之间有移行,肿瘤细胞核分裂象少见。免疫组化:CK、α-抗糜蛋白酶和EMA(+),溶菌酶、ER、PR和HER-2(-);PAS染色(抗淀粉酶后)(+)。结论乳腺腺泡细胞癌罕见,但具有特异的组织学特征和免疫表型,需要与乳腺分泌性癌、伴大汗腺分化的癌、富于脂质的癌和颗粒细胞瘤等相鉴别。该肿瘤有一定的复发及转移率,术后需密切随诊。Objective To investigate the clinicopatholocal features and differential diagnosis of acinic cell carcinoma （ACCA） in breast.Methods A case of ACCA in breast was studied with histology,immunohistochemistry and PAS stain,followed by review of literature.Results The tumor showed two types of cells：one was salivary gland acinar-like arranged in solid sheet,and the cells were large in size with prominent granular eosinophilic cytoplasm,and the nuclei was small and round with single small nucleoli or not distinct ; the second type of cells were also arranged in solid sheet,and the cells were smaller with fine granular eosinophilic cytoplasm,and the nuclei features were similar to the type one; these two types of cells had transitimal zone,and the mitotic figures were rare.The tumor cells were positive for CK,α-antichymotrypsin,EMA and PAS,but negative for lysozyme,ER,PR,HER-2,P63,CK5/6,S-100,and calponin.This tumor had relatively moderate risk for recurrence （20％） and metastasis （20％）.Conclusion The ACCA in breast is rare but with distinct histological and immunohistochemical characteristics.It should be distinguished from other tumors of the breast.In case of the recurrence and metastasis,follow-up after surgery is very necessary.

关 键 词：乳腺 腺泡细胞癌 诊断 

分 类 号：R737.9[医药卫生—肿瘤]