乳腺纤维瘤病样化生性癌临床病理观察  

Clinicopathological observation of fibromatosis-like metaplastic carcinoma of breast

作　　者：李嘉 李军扩[1] 雷瑞雪[1] 张萍[1] LI Jia;LI Junkuo;LEI Ruixue;ZHANG Ping(Department of Pathology,Anyang Tumor Hospital,Anyang 455000,China)

机构地区：[1]安阳市肿瘤医院病理科,河南安阳455000

出　　处：《肿瘤基础与临床》2021年第6期501-504,共4页journal of basic and clinical oncology

摘　　要：目的探讨乳腺纤维瘤病样化生性癌(FLMC)的临床病理特征、免疫表型、诊断和鉴别诊断要点。方法收集2例乳腺FLMC患者的临床资料,结合文献分析其病理特征及免疫组化特征。结果2例乳腺FLMC均为老年女性,年龄分别为64岁和72岁,大体肿物灰白色,质硬韧,1例实性,1例中央可见囊腔,直径3 cm和3.5 cm。镜下肿瘤组织由>95%的形态温和及轻度异型的梭形细胞组成,呈束状或旋涡状排列,浸润性生长,其间可见簇状或成片卵圆形及上皮样细胞,与梭形细胞相互移行,梭形细胞间见灶状鳞化。免疫组化雌激素受体、孕激素受体、人表皮生长因子受体-2为(-)、细胞角蛋白(CK)、CK5/6、P63、CD10、Vimentin为(+),CK7、上皮性钙黏蛋白、CD34为(-),Ki-67(+,10%~15%)。2例术后随访11和42个月,均健在,无复发及转移。结论乳腺FLMC属于罕见类型的梭形细胞化生性癌,具有特殊的组织学特征及免疫表型,淋巴结转移少见,预后较好。Objective To investigate the clinicopathological features,immunophenotype,diagnosis and differential diagnosis of breast fibromatosis-like metaplastic carcinoma(FLMC).Methods The clinical data of 2 cases of breast FLMCs were collected,and the pathological and immunohistochemical characteristics of FLMC were analyzed in combination with literature.Results Two cases of FLMC in breast were elderly women,aged 64 and 72 years respectively.The gross mass was grey,hard and tough.One case was solid and one case was cystic with a diameter of 3 cm and 3.5 cm.Microscopically,the tumor tissue consists of more than 95%spindle cells with mild and mild atypia,arranged in bundles or vortices and growing infiltratively.Clusters or patches of oval and epithelioid cells can be seen between them,migrating with spindle cells,and focal squamous differentiation can be seen between spindle cells.Immunohistochemistry:estrogen receptor,progesterone receptor and human epidermal growth factor receptor-2 were(-),cytokeratin(CK),CK5/6,P63,CD10,Vimentin(+),CK7,E-cadherin,CD34(-),Ki-67(+,10%-15%).Two patients were followed up for 11 and 42 months,and were alive without recurrence or metastasis.Conclusion FLMC is a rare spindle cell metaplastic carcinoma with special histological features and immunophenotype,lymph node metastasis is rare and the prognosis is good.

关 键 词：乳腺肿瘤 纤维瘤病样化生性癌 鉴别诊断 

分 类 号：R737.9[医药卫生—肿瘤]