乳腺原发性高分化脂肪肉瘤临床病理特征  

Clinicopathologic features of primary well-differentiated liposarcoma of breast

作　　者：任平[1] 宋春青[2] 杜睿[1] 刘红波[1] 霍艳丽[1] 祁晓莉[1] 

机构地区：[1]首都医科大学大兴医院病理科,北京102600 [2]首都医科大学大兴医院肿瘤内科,北京102600

出　　处：《诊断病理学杂志》2014年第7期454-456,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的讨论乳腺原发性高分化脂肪肉瘤的临床病理特征、诊断与鉴别诊断、治疗与预后。方法分析1例46岁女性乳腺原发性高分化脂肪肉瘤的临床病理特征及免疫组化标记,并文献复习。结果右乳肿物位于外上象限,直径3 cm,质硬,无触痛,边界欠清,与周围组织粘连。大体见肿物类圆形,切面灰黄色、分叶状,未见明显包膜,质脆;镜下脂肪母细胞多见,胞质可见单个或多个脂肪空泡,细胞核可见空泡压迹,见残存乳腺导管及小叶。免疫组化示S-100、MDM2、Ki-67和vimentin均(+),NF、ALK、SMA和desmin均(-)。结论乳腺原发性高分化脂肪肉瘤相当少见,临床与良性病变易混淆;细针穿刺时会误诊为良性;影像学与脂肪瘤难鉴别。诊断主要依靠术后病理诊断,特别要注意与一些乳腺良性病变的鉴别,以免误诊。手术方式与分化程度有关。Objective To discuss the clinical and pathologic features,pathologic diagnosis,differential diagnosis,therapy and prognosis of primary well-differentiated liposarcoma （PLP） of the breast.Methods A 46-year-old female with breast tumor was diagnosed as PLP.We analysed clinicopathologic features,histopathologic morphology and immunohistochemical findings,and related literature.Results The tumor was 3 cm in diameter and located in extrasuperior quadrant of the right breast.It was round,gray yellow,hard,lobulated and very brittle,without envelope,and it adhered to the surrounding tissue.The PLP had various subtypes on microscopic examination,lipoblasts were often found with single or multiple fat cavitation in cytoplasm and with nuclei trace by cavitation.Residual breast ducts and lobules were observed in the tumor.Immunohistochemically,staining for S-100,MDM2,Ki-67,and vimentin were negative,and NF,ALK,SMA,desmin and CK were positive,The case was diagnosed as PLP of the right breast.Conclusion PLP of breast is quite rare,it is easily confused with benign lesions in clinical practice; Fine needle puncture cytology can be misdiagnosed as benign sometimes; Imaging is difficult to be differentiated from lipoma.Diagnosis relies mainly on the postoperative pathological diagnosis.In order to avoid misdiagnosis,special attention should be paid to the differential diagnosis from some benign lesions of the breast.Surgical procedure is related to degree of differentiation.

关 键 词：脂肪肉瘤 临床病理特征 鉴别诊断 乳腺 

分 类 号：R736.1[医药卫生—肿瘤]