乳腺实性乳头状癌4例临床病理分析  

Clinicopathologic features of 4 cases of solid papillary carcinoma in breast

作　　者：郑桂华[1] 陈旭东[1] 

机构地区：[1]南通市肿瘤医院,江苏南通226361

出　　处：《基层医学论坛》2015年第30期4242-4244,F0002,共4页The Medical Forum

摘　　要：目的探讨乳腺实性乳头状癌（solid papillary carcinoma,SPC）的临床病理特征、免疫表型特点、鉴别诊断及预后。方法对4例SPC患者进行常规病理检查、免疫组化标记,并结合临床资料及相关文献进行分析。结果 4例SPC患者均为女性,发病年龄33岁～67岁,临床表现为乳头溢血1例,发现乳腺肿块3例。镜下见肿瘤被厚纤维分隔成巢状,肿瘤细胞巢内见纤细的纤维血管轴心,轴心周围细胞成栅栏状或围绕血管呈菊形团结构。瘤细胞轻度异型,可见细胞内、外黏液,核分裂象少见。免疫组化瘤细胞均表达ER、PR、Syn、CgA,瘤巢周围肌上皮CK5/6、SMA、P63散在阳性表达或不表达,乳头轴心肌上皮CK5/6、SMA、P63见阳性表达;Ki-67均为低表达（平均阳性指数2%）;C-erBb-2均为阴性。结论 SPC好发于老年女性,临床上多表现为乳头溢血或乳腺肿块,有独特的组织学及免疫组织化学特点,预后较好。Objective To explore the clinicopathologic features,immunophenotype, antidiastole and prognosis of solid papillary carcinoma （SPC） of breast. Methods 4 patients with SPC were treated by routine pathological examination, immunohistochemical markers, and clinical data, related literature were analyzed. Results The 4 patients were female, aged from33 to 67 years, the clinical manifestations of 1 cases of nipple blood dischargeand 3 cases of breast lumps were found. Microscopically, the tumor was divided into nests by thick fibers and that fine delicate fibrovascular septa were discovered amid the solid proliferation. The tumor cells were mild,mucus secretion were seen inside and outside the cell. Immunohistochemistry,the tumor cells showed the expression of ER, PR, Syn, CgA.CK5/6, SMA, P63 expression were seen on myoepithelial scattered positive or not around the tumor nests, but positive on myoepithelial of the papilla axis.The average of Ki-67 index of tumor cells was 2%.All case were negative for c-erbB-2.Conclusion SPC is predominantly found in elderly females with distinctive pathological features and immunophenotype,the clinical manifestations were nipple blood discharge or finding breast lumps, the prognosis is good.

关 键 词：乳腺肿瘤 实性乳头状癌 临床特征 病理分析 

分 类 号：R737.9[医药卫生—肿瘤]