乳腺纤维瘤病14例临床病理学分析及文献复习  

Breast fibromatosis:a clinicopathologic analysis of fourteen cases and review of literature

作　　者：涂金花[1] 黄艳[1] 付莉[1] 张海芳[1] 王玉环[1] 钟山[1] TU Jin-hua;HUANG Yon;FU Li;ZHANG Hai-fang;WANG Yu-huan;ZHONG Shan(Deparment of Pathology,The First Afiliated Hospial of Xiamen Universily,Xiamen 361000,China)

机构地区：[1]厦门大学附属第一医院病理科,福建厦门361000

出　　处：《诊断病理学杂志》2024年第4期318-322,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨乳腺纤维瘤病(BF)临床病理特征、诊断、鉴别诊断及预后。方法回顾性分析14例BF的影像及病理学、免疫组化特征和预后。结果患者年龄21~33岁,中位年龄25岁,均为女性,肿瘤大小0.7~4.5 cm,中位大小2.1 cm。镜下见形态温和的梭形细胞和胶原纤维束状排列,浸润乳腺实质,局部淋巴细胞浸润,以边缘区最明显。免疫组化:7例β-catenin核阳性,11例SMA阳性;9例Desmin阳性;CKpan、CK5/6、p63、ER、PR、CD34、S-100均呈阴性,Ki-67均小于5%。随访期内均未见复发、转移。结论BF为少见的乳腺间质肿瘤,临床易误诊为癌,细针穿刺病理同样易漏诊、误诊;正确的诊断有赖于病理检查。多学科诊疗治疗模式下,综合评估肿瘤生长进展、肿瘤负荷和并发症等情况选择合理的综合治疗策略非常重要。Objective To investigate the clinicopathologic feature,diagnosis,differential diagnosis and prognosis of breast fibromatosis(BF).Methods The clinical and imaging manifestations as well as histological and immunohistochemical characteristics of 14 patients with BF were analyzed and summarized.Results The age of ranged from 21 to 33 years(median 25 years).There were all females.Diameter of tumors was from 0.7 cm to 4.5 cm(median 2.1 cm).Among 14 cases,Microscopically,there was a proliferation of spindle cells,parallel to one another and arranged in long,sweeping fascicles within a fibrous background.The tumor cells infiltrated the breast parenchyma.Lymphocytes were visible at the edges.According to immunohistochemical study,7 cases wereβ-catenin positive,11 cases were SMA positive,9 cases were desmin positive,while cytokeratin,CKpan,CK5/6,p63,ER,PR,CD34 and S-100 were negative.Ki-67 was less than 5%.There was no recurrence and metastasis after complete resection of the tumor.Conclusion Breast fibromatosis is rare and often clinically mistaken for carcinoma.Fine needle puncture pathology is also easy to miss diagnosis and misdiagnosis.The correct diagnosis depends on the pathological examination.It is very important to select a reasonable comprehensive treatment strategy based on tumor growth progression,tumor load and complications by multi-disciplinary treatment mode.

关 键 词：乳腺 纤维瘤病 临床病理 预后 鉴别 

分 类 号：R739[医药卫生—肿瘤]