乳腺伴极性翻转的高细胞癌临床病理学特征分析  

Clinicopathological characteristics of tall cell carcinoma with reversed polarity of breast

作　　者：高巍松 杜艳[1] 赵华[1] 徐祎 张智弘 范钦和 印永祥[1] 王聪 GAO Weisong;DU Yan;ZHAO Hua;XU Yi;ZHANG Zhihong;FAN Qinhe;YIN Yongxiang;WANG Cong(Department of Pathology,Jiangsu Province of Wuxi Maternity and Child Health Care Hospital,Women’s Hospital of Jiangnan University,Wuxi 214000,China;Department of Pathology,Jiangsu Province Hospital/the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]江苏省无锡市妇幼保健院/江南大学附属妇产医院病理科,无锡214000 [2]江苏省人民医院/南京医科大学第一附属医院病理学部,南京210029

出　　处：《临床与实验病理学杂志》2023年第8期935-939,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：无锡市太湖人才计划高层次人才培养项目(BJ2020072);无锡市妇幼保健院学科带头人课题项目(TY2020006)。

摘　　要：目的探讨乳腺伴极性翻转高细胞癌(tall cell carcinoma with reversed polarity,TCCRP)的临床病理学特征、诊断、鉴别诊断。方法收集4例TCCRP患者的临床资料,采用HE、免疫组化EnVision法染色、Sanger测序技术进行检测,分析其临床病理特征并复习相关文献。结果4例患者平均年龄56.5岁,以乳腺肿块或乳头溢液就诊。肿瘤最大径1.8~0.7 cm,灰白色实性结节状。镜下肿瘤细胞呈实性巢状、膨胀性浸润模式,有纤细纤维血管轴心的实性乳头样结构,高柱状、立方状肿瘤细胞呈栅栏排列,细胞核呈圆形或卵圆形,可见极性翻转的特征性表现:细胞核远离基底。免疫表型:三阴型或激素受体呈局灶弱阳性,Ki-67增殖指数低;Calretinin、GATA3、TRPS1、CK5/6、CK14等均阳性;Calponin、p63等阴性。3例IDH2免疫组化检测均阳性,Sanger检测4例均存在IDH2 R172突变。结论TCCRP属于罕见的低度恶性乳腺癌亚型;具有独特的组织学、免疫表型和分子特征,大多数患者临床病程缓慢、预后较好。Purpose To explore the clinical pathological characteristics of tall cell carcinoma with reversed polarity of breast(TCCRP)to improve the understanding and diagnosis of TCCRP.Methods The clinical data of 4 TCCRP patients were collected;HE,immunohistochemistry EnVision staining,and SangeRsequencing technology were used in this study.TheiRclinical pathological characteristics were analyzed,with review of relevant literature.Results Among the 4 patients,the average age was 56.5 years.Most of them presented with a breast mass oRnipple discharge,which ranged from 0.7 to 1.8 cm in size and were described as gray and solid.Microscopically,tumoRcells had solid nest-like expansive infiltrating growth,solid papillary structures with slendeRfibrovasculaRaxes.TumoRcells were arranged in a high column,oRcubic fence,and the nucleus was round oRoval.Reverse nucleaRpolarity was observed in some areas.Immunophenotypically,these tumors showed a triple-negative immunophenotype oRlocal weak positive expression and a low proliferative index.Calretinin,GATA3,TRPS1,CK5/6 and CK14 were positive in the tumor.Calponin and p63 were negative.Immunohistochemical detection of IDH2 was performed in three patients with positive expression.All fouRpatients had IDH2 R172 mutations.Conclusion TCCRP is a rare subtype of carcinoma with low systemic dissemination potential.It has unique histological,immunohistochemical,and moleculaRfeatures,and most cases have a slow clinical course and a good prognosis.

关 键 词：乳腺肿瘤 极性翻转高细胞癌 临床病理分析 分子表型 

分 类 号：R737.9[医药卫生—肿瘤]