乳腺小叶型腺肌上皮瘤临床病理分析  

Clinicopathological analysis about lobular adenomyoepithelioma of breast

作　　者：张玉文[1] 李晓丽[1] 秦珍珠[1] 李晓旭[1] ZHANG Yu-wen;LI Xiao-li;QIN Zhen-zhu;LI Xiao-xu(The First People's Hospital of Shangqiu,Shangqiu,Henan,476000,China)

机构地区：[1]商丘市第一人民医院,河南商丘476000

出　　处：《新疆医学》2023年第1期35-38,共4页Xinjiang Medical Journal

基　　金：河南省医学科技攻关计划项目(项目编号2018020948)。

摘　　要：目的 探讨乳腺小叶型腺肌上皮瘤(Adenomyoepithelioma,AME)的临床病理特征。方法 收集商丘市第一人民医院2016年3月-2020年7月确诊的5例AME的临床病理资料,调阅病理切片,免疫组化法检测相应指标表达情况,并查阅相关文献总结其临床病理学特征。结果 5例组织学形态均为小叶亚型腺肌上皮瘤,2例术中冰冻诊断误诊为低级别导管内癌及小叶原位癌。组织学上主要由增生的肌上皮和腺上皮间质构成,各成分因病例不同而变化,增生的肌上皮形态不一,围绕被覆腺腔上皮的小腺腔,腔内可见坏死样物,免疫组化显示腺上皮表达CK、CK7,肌上皮表达P63、Calponin、S-100、CK5/6。5例ER和PR染色阴性或灶状弱阳性,HER-2均为阴性,Ki-67指数约10%-30%。5例均行手术切除治疗,术后未行进一步辅助治疗,截至末次随访,5例患者均未发生肿瘤复发和转移。结论 乳腺小叶型AME是一种少见的乳腺病变,形态学上多种多样,在术中及常规病理诊断中极易误诊为导管内癌、小叶瘤变及浸润性癌,了解其临床病理特征及免疫组化特点,可有效减少误诊。Objective To explore the clinicopathological characteristics of lobular adenomyoepithelioma(AME) of breast.Methods Clinical pathological data of 5 cases diagnosed with AME at the first People’s hospital of Shangqiufrom March 2016 to July 2020 were collected. pathological information were analyzed, immunohistochemistry test was used to detect the expression of corresponding indicators, and relevant literature about their clinical pathological characteristics were reviewed. Results The histological morphology of 5 cases all belonged to lobular subtype adenomyoepithelioma, and 2 cases were misdiagnosed as low-grade intraductal carcinoma and lobular carcinoma in situdue to frozen diagnosis during the operation.Immunohistochemistry showed that glandular epithelium expressed CK and CK7, and myoepithelial expressed P63, Calponin, S-100, CK5/6. In these 5 patients, ER and PR staining were negative or focal weakly positive, and HER-2 was negative, and the Ki-67 index was about 10%-30%. 5 patients underwent surgical resection, and no further adjuvant treatment was given after the operation. As of the last follow-up, no tumor recurrence or metastasis occurred in 5 patients. Conclusion Lobular breast AME is a rare breast disease, which can easily be misdiagnosed as intraductal carcinoma, lobular neoplasia and invasive carcinoma during surgery and routine pathological diagnosis. Understanding its clinicopathological and immunohistochemical characteristics can effectively reduce misdiagnosed.

关 键 词：腺肌上皮瘤 小叶型腺肌上皮瘤 乳腺 

分 类 号：R737[医药卫生—肿瘤]