老年女性乳腺分泌型癌一例临床病理特征及文献复习  

Secretory carcinoma of the breast: a clinicopathological analysis of one elderly femalecase and literature review

作　　者：魏灿灿 张永平 寇真真 谭新平 李辉[2] 刘新权[2] 徐春玲 严丹丹 袁静萍[1] Wei Cancan;Zhang Yongping;Kou Zhenzhen;Tan xinping;Li hui;Liu Xinquan;Xu Chunling;Yan Dandan;Yuan Jingping(Department of Pathology,Renmin Hospital of Wuhan university,Wuhan 430060;Department of Pathology,Fifth Dvision Hospital of Xinjiang Production and Construction Corps,Bole 833400;Department of Pathology,Renmin Hospital of Shayang County,Jingmen 448200;Department of Neurology,Fifth Dvision Hospital of Xinjiang Production and Construction Corps,Bole 833400)

机构地区：[1]武汉大学人民医院病理科,武汉430060 [2]新疆生产建设兵团第五师医院病理科,博乐833400 [3]沙洋县人民医院病理科,荆门448200 [4]新疆生产建设兵团第五师医院神经内科,博乐833400

出　　处：《中国组织化学与细胞化学杂志》2020年第4期345-348,共4页Chinese Journal of Histochemistry and Cytochemistry

基　　金：武汉市科技计划项目(2017060201010172);武汉大学人民医院引导基金(RMYD2018M27)。

摘　　要：目的了解老年女性乳腺分泌型癌(secretory carcinoma of the breast,SCB)的临床病理特征、免疫组织化学表型、鉴别诊断及预后。方法应用HE染色及免疫组织化学技术观察并分析本院病理科会诊的一例乳腺癌患者的临床病理特点及免疫组织化学表型,并总结相关文献。结果患者女性,63岁,肿块位于左侧乳腺,肿块大小约为2×1.5cm,切面灰白灰黄,边界不清,无包膜。低倍镜下肿瘤细胞呈巢团状、微囊状、小管状分布,高倍下可见肿瘤细胞温和、异型性不明显、核分裂象罕见,胞浆丰富,嗜酸性,常呈空泡状,内含分泌物质。免疫组织化学染色显示肿瘤细胞ER、PR、HER-2、CK5/6均阴性,Ki-67增殖指数约为5%,S-100阳性表达;特殊染色:分泌物黏液卡红、AB-PAS阳性。结论乳腺分泌型癌是乳腺癌中较为罕见的一种亚型肿瘤,其恶性程度较低,在形态学、免疫组织化学上具有一定的特殊性,预后较其他类型乳腺癌好,但老年患者预后较差。Objective To understand the clinicopathological features,immunohistochemical phenotype,differential diagnosis and prognosis of secretory carcinoma of breast(SCB)in elderly women.Methods HE staining and immunohistochemical staining were used to observe and analyze the clinicopathological characteristics and immunophenotype of a case of breast cancer consulted by the pathology department of our hospital,and the relevant literature was reviewed.Results The case was a 63-year-old woman.The tumor was located in her left breast and poorly demarcated.The tumor size was about 2cm×1.5cm,its cut surface was grayish-white to gray-yellow,with unclear borders and no capsule.Under low magnification microscope,the tumor cells showed nests,microsacs,and tubules appearance.Under high magnification microscope,the tumor cells were mild,the atypia was not obvious,and the mitotic figure was rare,the cytoplasm was abundant,eosinophilic and often vacuolated with secreted substances.Immunohistochemical stain-ing showed that ER,PR,HER-2 and ck5/6 were all negative,Ki-67 label index was low(about 5%)and S-100 was positive.Special stains:the secretion mucus was positive in Carmine staining and AB-PAS staining.Conclusion SCB is a rare subtype of breast cancer.It showed a low degree of malignancy and specific morphology and immunohistochemistry.The general prognosis of SCB is better than other types of breast cancer,but the prognosis of elderly patients is poor.

关 键 词：乳腺肿瘤 分泌型癌 临床病理特征 鉴别诊断 预后 

分 类 号：R737.9[医药卫生—肿瘤]