乳腺浸润性上皮病背景下原位癌9例临床病理特征分析  

Clinicopathological features of carcinoma in situ in the background of breast infiltrating epithelisis: a report of nine cases

作　　者：何泽生 王莉萍 杨毅斌 郑良楷 孔令员 HE Ze-sheng;WANG Li-ping;YANG Yi-bin;ZHENG Liang-kai;KONG Ling-yuan(Department of Pathology,Women and Children's Hospital,School of Medicine,Xiamen University,Xiamen 361003,China)

机构地区：[1]厦门大学附属妇女儿童医院,厦门市妇幼保健院病理科,福建厦门361003

出　　处：《诊断病理学杂志》2024年第2期132-134,139,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨在乳腺浸润性上皮病(IE)背景下原位癌的组织病理学、免疫组织化学染色特征,讨论其诊断与鉴别诊断。方法收集9例IE背景下原位癌,采用自动免疫组织化学仪检测雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER-2)、Ki-67等项目。结果9例均为中老年女性,影像表现为多发性结节;镜下表现为:上皮增生旺盛,形成不规则的上皮巢,缺乏小叶结构特征,形成浸润样形态,可以累及周围脂肪组织及神经被膜;肌上皮均存在,但在硬化性区域,肌上皮减少。结论IE背景下发生原位癌出现缺乏小叶结构的特征时,类似浸润样形态,容易过诊断为浸润性癌。同时,癌灶常较广,建议扩切或乳腺单纯切除,同时要考虑双侧乳腺癌可能性。Objective To investigate the histopathology and immunohistochemical features of carcinoma in situ in the background of breast infiltrating epithelisis(IE), and to discuss its diagnosis and differential diagnosis. Methods Nine cases were collected, and estrogen receptor(ER), progesterone receptor(PR), human epidermal growth factor receptor 2(HER-2), Ki-67 and other items were detected by automatic immunohistochemistry. Results All 9 cases were middleaged and elderly women with multiple nodules. Under the microscope, the epithelium showed hyperplasia, forming irregular epithelial nests, lacking lobular structural features, forming infiltrating morphology, which could involve the surrounding adipose tissue and nerve envelope. Myoepithelium was present in all cases, but in the sclerosing area, myoepithelium was reduced. Conclusion In the case of carcinoma in situ in the background of IE, when the feature of absence of lobular structure is similar to the infiltrating form, it is easy to be overdiagnosed as invasive carcinoma. At the same time, the cancer is often more extensive, so it is recommended to enlarged or simple mastectomy, and the possibility of bilateral breast cancer should be considered.

关 键 词：浸润性上皮病 乳腺原位癌 假性浸润 缺乏小叶结构特征 肌上皮减少或缺失 

分 类 号：R73[医药卫生—肿瘤]