乳腺纤维瘤病样化生性癌3例报告并文献复习  

Fibromatosis metaplastic breast carcinoma:report of 3 cases and review of literature

作　　者：王果元[1] 鹿芃恬 孙玉兰[1] 张旭[1] 贾影[1] WANG Guo-yuan;LU Peng-tian;SUN Yu-lan;ZHANG Xu;JIA Ying(Department of Pathology,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一医院病理科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2024年第3期335-338,共4页Journal of Harbin Medical University

基　　金：哈尔滨医科大学附属第一医院科研创新基金(2023M02)。

摘　　要：目的探讨乳腺纤维瘤病样化生性癌(fibromatosis like metaplasia carcinoma,FLMC)的病理组织学特点、免疫组化表型,诊断及鉴别诊断。方法收集2016年9月~2020年4月哈尔滨医科大学附属第一医院3例女性FLMC患者,对乳腺纤维瘤病样化生性癌进行病理组织学形态、免疫组化等特点进行观察分析。结果3例患者均具有乳腺无痛、质硬肿物。组织形态学显示肿瘤细胞呈梭形,细胞密度不均,形态温和,轻-中度异形,梭形细胞弥漫或相互交错排列,间质纤维组织增生伴胶原化,肿瘤边缘区域可见呈指突状浸润周围乳腺实质及纤维脂肪组织。免疫组化梭形肿瘤细胞均表达上皮标记CK、CK5/6、34βE12、CAM5.2、CK8/18、CK7、CK14、P63、BCL2、Vimentin、SMA、β-catenin、CD10、Calponin“+”,ER、PR、C-erBb2、CD34、E-cadherin、S-100、P120、GFAP“-”。随访至今,均未见肿瘤复发及转移。结论乳腺纤维瘤病样化生性癌是一类罕见的病变,形态学温和,易误诊,免疫组化对其鉴别诊断有帮助。Objective To investigate the histopathological features,immune profile,diagnosis and differential diagnosis of fibromatosis like metaplasia carcinoma(FLMC)of the breast.Methods Three female cases of breast fibromatosis-like metaplasiacarcinoma in the First Affiliated Hospital of Harbin Medical University from September 2016 to April 2020 were collected,pathological and immunohistochemical characteristics of FLMC were observed and analyzed.Results All the patients had touch painless and hard masses in the breasts.Histologically,the tumor cells were spindle with uneven cell density,mild to moderate heteromorphism,diffuse or staggered,interstitial fibrous tissue hyperplasia with collagenation,finger process infiltration of surrounding breast parenchyma and fibrous fat tissue were found in the marginal area of the tumor.Immunohistochemical staining showed that epithelial markers CK,CK5/6 and 34βE12,CAM5.2,CK8/18,CK7,CK14,P63,BCL2,Vimentin,SMA,β-catenin,CD10,Calponin“+”,while,ER,PR,C-erBb2,CD34,E-cadherin,S-100,P120,GFAP“-”were expressed in spindle tumor cells of those three cases.No tumor recurrence and metastasis was found at the end of follow-up.Conclusion Fibromatosis metaplastic breast carcinoma is a rare lesion with mild morphology and easy to be misdiagnosed.Immunohistochemistry is helpful to its differential diagnosis.

关 键 词：乳腺 纤维瘤病样化生性癌 临床病理表现 

分 类 号：R737.9[医药卫生—肿瘤]