乳腺炎性肌纤维母细胞瘤1例临床病理观察  

Inflammatory myofibroblastic tumor of the breast:a clinicopathologic study of one case

作　　者：谭敏华[1] 陈威[1] 邹绮嫦[1] 郭锦辉[1] 周泳健 欧瑞芬 邓超桦[1] 胡志雄[1] 雷伟华[1] TAN Min-hua;CHEN W ei;ZOU Qi-chang;GUO Jin-hui;ZHOU Yong-jian;OU Rui-fen;DENG Chao-hua;HU Zhixiong;LEI Wei-hua(Department of Pathology,Zhaoqing First P eople's Hospital,Zhaoqing 526060,Guangdong,C hina)

机构地区：[1]肇庆市第一人民医院病理科,广东肇庆526060

出　　处：《诊断病理学杂志》2020年第7期472-475,共4页Chinese Journal of Diagnostic Pathology

基　　金：肇庆市科技创新指导类项目(201704031411)。

摘　　要：目的探讨乳腺炎性肌纤维母细胞瘤(IMT)临床病理特征,免疫表型与诊断、鉴别诊断的相关性。方法对1例乳腺IMT进行临床病理组织学观察,结合免疫组化结果,复习相关文献。结果女性46岁,右乳外下象限扪及肿块7个月,边界清。肉眼肿瘤灰白,切面质实。镜检瘤组织以增生梭形细胞为主,核梭形或三角形,深染,异型,核分裂少见,间质见多少不等淋巴细胞、浆细胞、组织细胞和纤维胶原化组织,间质水肿。免疫组化:瘤细胞vimentin、SMA、actin均为弥漫(+),ALK部分(+),Desmin灶性(+),bcl-2、CK、p63、CD68、CD34、S-100、CD10、CD117、β-catenin均为(-),Ki-67阳性指数约5%。随访40个月,无瘤生存。结论乳腺IMT是一种比较少见的间叶性肿瘤,影像学检查与疤痕组织相似,易误诊,病理组织学检查,与炎症反应纤维组织增生相似,易漏诊,免疫组化有助于病理诊断及鉴别诊断。Objective To investigate the clinicopathologic features and the correlation between immunophenotype,diagnosis and differential diagnosis of inflammatory myofibroblastic tumors(IMT)of the breast.Methods A case of breast inflammatory myofibroblastic tumor was studied by clinicopathologic observation,combined with immunohistochemical results,and the relevant literature was reviewed.Results A 46-year-old female presented with a palpable mass in the lower right breast for 7 months.The gross tumor was pale and parenchymal solid in section.Microscopically,the tumor was composed of proliferating spindle cells,with spindle-shaped or triangular nuclei,hyperchromatism,atypia,rarely mitotic figures,and varying amounts of lymphocyte,plasmacytes,histiocyte,collagenous fibers,and interstitial edema were also present.The immunohistochemical results showed that the tumor cells were diffusely positive for vimentin,SMA and actin,partially positive for ALK and focal positive for desmin;Bcl-2,CK,P63,CD68,CD34,S-100,CD10,CD117,β-catenin were all negative;the positive index of Ki67 was about 5%.The patient was followed up for 40 months and survived without tumors.Conclusion IMT of breast is a relatively rare mesenchymal tumor,imaging examination is similar to scar tissue,easy to be misdiagnosed;histopathological examination is similar to inflammatory reaction fibrous tissue hyperplasia,easy to missed diagnosis;immunohistochemistry is helpful in the pathological diagnosis and differential diagnosis.

关 键 词：炎性肌纤维母细胞瘤 乳腺 临床病理特征 免疫组化 

分 类 号：R365[医药卫生—病理学]