乳腺腺样囊性癌4例临床病理特征分析  

Adenoid cystic carcinoma of the breast:a clinicopathological analysis of four cases

作　　者：刁为英[1] 王彩霞[1] 岳农灏 王桂梅[1] 聂美楠[1] 郭爱桃[3] DIAO Wei-ying;WANG Cai-xia;YUE Nong-hao;WANG Gui-mei;NIE Mei-nang;GUO Ai-tao(Department of Pathology,the First Affiliated Hospital,College of Medicine,Jiamusi University,Jiamusi 154002,China;Department of Pathology,the Central Hospital of Jiamusi,Jiamusi 154002,China;Department of Pathology,the General Hospital of PLA,Beijing 100853,China)

机构地区：[1]佳木斯大学附属第一医院病理科,黑龙江佳木斯154002 [2]佳木斯市中心医院病理科,黑龙江佳木斯154002 [3]解放军总医院病理科,北京100853

出　　处：《诊断病理学杂志》2018年第9期625-628,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨4例乳腺腺样囊性癌的病理形态特征、免疫表型及诊断要点。方法收集4例乳腺腺样囊性癌患者的临床资料,结合文献分析乳腺腺样囊性癌的病理特征及免疫组化特点。结果 4例乳腺腺样囊性癌患者均为女性,年龄50~68岁。肿物多位于乳晕区,界线清楚,切面灰白或灰黄色,呈分叶状或囊性;镜下肿瘤细胞呈浸润性生长,由筛状、突体型和梁-管状结构组成,肿瘤实质主要由腺上皮、肌上皮及基底样细胞构成。免疫组化:肿瘤细胞ER、PR和c-erb B-2均(-),腺上皮细胞CK5/6、CK7和CD117(+),肌上皮细胞p63和CK5/6(+),基底样细胞不同程度p63、CK5/6和CD117(+)。4例随访4~65个月,1例局部复发,4例均无转移。结论乳腺腺样囊性癌为低度恶性肿瘤,具有独特的组织病理学特征及免疫表型,预后较好,罕见发生淋巴结及远处转移。Objective To report 4 cases of adenoid cystic carcinoma with analysis of its clinical and pathological features,immunohistochemical phenotype and diagnostic points. Methods The clinical and pathological characteristics were collected in 4 cases of breast adenoid cystic carcinoma and the immunohistochemical features of the cancer were retrospectively analyzed. Results The 4 patients with breast adenoid cystic carcinoma were female,aged 50-68 years;the tumors were mostly located in the areola area,with clear boundary,pale or gray yellow colour,and lobulated or cystic shape; microscopically, these tumor cells showed an infiltrative growth with cribriform, trabecula-tubular and solid patterns; the tumors mainly consisted of glandular epithelium, myoepithelial cells and basaloid cells. The immunohistochemistrically stained results showed that the tumor cells of ER,PR and C-erb B-2 were all negative. The glandular epithelial cells expressed CK5/6,CK7 and CD117. The myoepithelial cells expressed p63 and CK5/6. The basaloid cells expressed P63,CK5/6 and CD117 with different degrees. Follow-up for 4 to 65 months showed that 1 patient had local relapse and 4 patients had no metastasis. Conclusions Breast adenoid cystic carcinoma is a low-grade malignant tumor,with its unique histopathologic characteristics and immunophenotype. The prognosis is good,and the incidence of lymph node and distant metastasis is rare.

关 键 词：乳腺腺样囊性癌 病理特征 免疫组化 

分 类 号：R737.9[医药卫生—肿瘤]