34例乳腺实性乳头状癌伴浸润的临床病理分析  

Clinicopathological Analysis of 34 Cases of Breast Solid Papillary Carcinoma with Invasion

作　　者：邹子归 周晋星 黄山[1] 王玉红 刘卫硕[1] 黄仁鹏[1] ZOU Zi-gui;ZHOU Jin-xing;HUANG Shan;WANG Yu-hong;LIU Wei-shuo;HUANG Ren-peng(Department of Pathology,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China;Department of Pathology,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu,210029,China)

机构地区：[1]苏州大学附属第一医院病理科,江苏苏州215006 [2]南京医科大学第一附属医院病理科,江苏南京210029

出　　处：《中国血液流变学杂志》2020年第4期528-531,F0002,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨实性乳头状癌(SPC)伴浸润病例的临床病理学特征、免疫表型、诊断及鉴别诊断.方法回顾性分析34例SPC伴浸润患者的影像学、病理形态学资料及免疫组织化学表达,并复习相关文献.结果患者均为女性,年龄52~87岁,平均69岁.21例发生于右乳,13例发生于左乳.特征性的临床表现为乳头溢血、溢液及乳房胀痛.肿瘤最大径0.6~14.0 cm,组织学表现为大小不一的实性膨胀性结节,结节内可见纤维血管轴心,部分病例可见明显细胞外黏液,伴黏液湖形成,肿瘤细胞较一致,细胞核轻度或中度异型,核染色质细,较淡染,核仁不明显.免疫组化显示ER均呈现不同程度的阳性,PR阳性表达率85.3%,Syn阳性表达率67.6%,CgA阳性表达率32.4%,肌上皮标记P63、CD10、Calponin均出现缺失.结论SPC是一种低度恶性肿瘤,呈惰性生物学行为,其形态学和免疫表型都具有独特的特征.SPC好发于老年女性,无论是否伴有浸润,预后均较好.Objective To investigate the clinicopathological characteristics,immunophenotypes,diagnosis and differential diagnosis of solid papillary carcinoma(SPC)with invasion.Methods The imaging,pathological data and immunophenotypes of 34 cases of SPC with invasion were studied retrospectively,and relevant literatures were reviewed.Results The patients were all female,aged 52-87 years,with an average of 69 years.21 cases occurred in the right breast and 13 cases occurred in the left.The characteristic clinical manifestations are nipple hemorrhage,discharge and breast tenderness.The maximum diameter of the tumor was 0.6-14.0 cm.Histologically,fibrovascular axis can be seen in the nodules,obvious extracellular mucus accompanied and the formation of mucus lakes can also be seen in some cases.The tumor cells were relatively consistent,the nuclei were mildly or moderately atypia,with fine nuclear chromatin and lightly stained nucleoli.Immunohistochemistry showed that ER was positive in varying degrees.The positive expression rate of PR,Syn and CgA was 85.3%,67.6%and 32.4%,respectively.While the myoepithelial markers P63,CD 10,and Calponin were all missing.Conclusion SPC is a low-grade malignant tumor with inert biological behavior and unique characteristics.SPC is more common in elderly women,and the prognosis is good regardless of whether it is accompanied by invasion.

关 键 词：实性乳头状癌 实性乳头状癌伴浸润 乳腺肿瘤 免疫组化 

分 类 号：R446.8[医药卫生—诊断学] R737.9[医药卫生—临床医学]