乳腺浸润性微乳头状癌(黏液亚型)2例临床病理观察  

Invasive micropapillary carcinoma( mucinous subtype) of breast: a clinicopathological study of two cases

作　　者：袁修学[1] 杨月红[2] 梅启慧[2] 聂秀[3] 郭涛[3] 邓雅尹[2] 袁静萍[4] 

机构地区：[1]武汉科技大学基础医学院,武汉430065 [2]武汉市中心医院病理科,武汉430014 [3]华中科技大学同济医学院附属协和医院病理科,武汉430022 [4]武汉大学人民医院病理科,武汉430060

出　　处：《诊断病理学杂志》2015年第6期324-327,共4页Chinese Journal of Diagnostic Pathology

基　　金：湖北省武汉市卫生局立项课题(WX12C58);湖北省自然科学基金课题(2013CFB374)

摘　　要：目的探讨乳腺浸润性微乳头状癌(IMPC)(黏液亚型)的临床病理特征、诊断与鉴别诊断。方法分析2例乳腺黏液亚型浸润性微乳头状癌临床资料,观察其组织学形态及免疫表型特征,并复习相关文献。结果 2例均为中、老年女性,均以发现乳腺肿块就诊。组织学显示,肿瘤细胞呈微乳头状,漂浮在黏液中,瘤细胞外周有一透明的腔隙。免疫组化:Her-2(3+),腺体外周EMA(+),ER、PR和EGFR(-),Ki-67增殖指数为30%。Her-2的FISH检测结果为(+)。结论乳腺浸润性微乳头状癌(黏液亚型)是一种罕见的预后差的乳腺恶性肿瘤,需要与乳腺单纯型黏液癌进行鉴别,依据临床和病理组织学特点,结合免疫组化染色可以明确诊断。Objective To explore the clinicopathological features,diagnosis and differential diagnosis of mucinous subtype of invasive micropapillary carcinoma （IMPC） of the breast.Methods By analysis of the clinical data in 2 cases of IMPC,the histological morphology and immunohistochemical characteristics of IMPC were studied,and their relevant literatures were reviewed.Results The female patients were 64 and 54 years old,respectively.Both presented with a mass found in the left breast.Histologically,the tumor presented a micropapillary architectural pattern floating in the mucus,with a transparent lacuna around the tumor cells.Immunohistochemically,both showed ER（-）,PR（-）,HER2 （3 ＋）,EGFR（-）,EMA （gland peripheral area ＋）,and Ki-67 proliferation index of approximate 30％.FISH test results of HER2 amplification were positive.Conclusions The IMPC （mucinous subtype） is a rare malignant tumor of breast with a poor prognosis,which requires to be differentiated from pure mucinous breast carcinoma （PMBC）.According to the clinical and histopathologic features of IMPC,definite diagnosis can be made in combination with the immunohistochemical staining.

关 键 词：浸润性微乳头状癌 黏液亚型 临床病理学 免疫组化 

分 类 号：R739.9[医药卫生—肿瘤]