乳腺原发性黏液性囊腺癌临床病理观察  

Clinicopathologic features of primary mucinous cystadenocarcinoma of the breast

作　　者：平静[1] 周东华[1] 田杰[1] 陈莹[1] 范菊花[1] 朱婧[2] PING Jing;ZHOU Dong-hua;TIAN Jie;CHEN Ying;FAN Ju-hua;ZHU Jing(Department of Pathology;Department of the Center of Breast Diseases,Maternal and Children＇s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市妇幼保健院病理科,广东佛山528000 [2]佛山市妇幼保健院乳腺疾病防治中心,广东佛山528000

出　　处：《诊断病理学杂志》2018年第7期521-524,529,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨乳腺原发性黏液性囊腺癌(MCA)的临床病理特征、免疫组化及鉴别诊断。方法对1例乳腺原发性MCA进行病理形态学及免疫组化分析,并复习相关文献。结果乳腺原发性MCA肉眼观肿块与周围组织分界较清,切面囊实性,囊内为黏液样物质。镜下可见大小不等的囊腔,囊壁内衬柱状上皮,细胞质内富含黏液,细胞核位于基底部。部分囊壁肿瘤细胞形成细胞簇或有纤维血管轴心的乳头状结构。部分肿瘤细胞质内黏液减少,出现不同程度的异型性,向鳞状上皮分化。免疫组化:肿瘤细胞E-cadherin和CK7(+),PR和c-erb B-2(2+),Ki-67阳性指数为55%、CK20、ER和GATA3(-)。结论乳腺原发性MCA是一种罕见肿瘤,需要与来自卵巢、胰腺或肠道的转移性肿瘤、乳腺柱状细胞黏液癌、乳腺黏液囊肿样病变等鉴别。确诊需结合组织学形态、免疫组化及临床病理资料综合分析。Objective To investigate the clincopathological features,immunohistochemical phenotypes and differential diagnosis of mucinous cystadenocarcinoma of the breast. Methods One case of primary mucinous cystadenocarcinoma of the breast was studied by light microscopy and immunohistochemical technique,with review of the literature. Results Grossly,the tumor appeared to be well demarcated,solid and cystic,and contained mucoid material. Microscopically,variably sized cystic spaces were lined by columnar mucinous cells with basally placed nuclei and abundant intracytoplasmic mucin. Cyst walls showed epithelial tufts or papillary proliferations with delicate fibrovascular cores. The mucinous cell type was transformed to one with more atypia and eosinophilic cytoplasm with mucin depletion,resulting in a squamoid appearance. The expression of E-cadherin,CK7,PR,C-erb B-2 was detected,and PR was elevated at 10 percent. CK20,ER and GATA3 were not expressed by immunohistochemical staining. Ki-67 was elevated at 55 percent. Conclusions Mucinous cystadenocarcinoma of the breast is a rare tumor. It should be distinguished from ovarian,pancreatic,or colonic mucinous cystadenocarcinoma metastatic to the breast,columnar cell mucinous carcinoma and the mucocele-like lesions in the breast; the diagnosis should be combined with histology,immunohistochemical results and clinicopathological data.

关 键 词：乳腺肿瘤 产生黏液的癌 黏液性囊腺癌 

分 类 号：R737.9[医药卫生—肿瘤]