乳腺颗粒细胞瘤6例临床病理特征分析  

Clinicopathological characteristics of breast granular cell tumors:Analysis of six cases

作　　者：张转敏 王映梅 胡沛臻 马世荣 ZHANG Zhuan-min;WANG Ying-mei;HU Pei-zhen;MA Shi-rong(Department of Pathology,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710033,China;Department of Pathology,Baoji Central Hospital,Baoji 721008,China)

机构地区：[1]空军军医大学第一附属医院病理科,西安710032 [2]宝鸡市中心医院病理科,陕西宝鸡721008

出　　处：《诊断病理学杂志》2024年第9期834-837,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨乳腺颗粒细胞瘤(GCT)的临床病理学特征、诊断及鉴别诊断要点、治疗及预后,并进行相关文献复习,旨在提高临床及病理医师对该疾病的认识水平。方法收集2014年3月至2022年3月空军军医大学第一附属医院手术切除的5例以及会诊的1例乳腺发生的颗粒细胞瘤患者,进行回顾性总结,分析临床病理特征。结果6例乳腺GCT瘤细胞成巢状、索状或者实性片状排列,细胞体积大,圆形、卵圆形或者多边形,胞质富含大量嗜酸性颗粒,核小圆形、深染、居中,核仁不明显,未见核分裂象及肿瘤性坏死。瘤组织被大量粗细不一的胶原纤维束分割。肿瘤周围未见明显包膜,边界不清,瘤细胞常围绕乳腺导管及小叶呈浸润性生长,并围绕神经束及血管分布,部分肿瘤细胞常浸润至周围纤维脂肪组织中,免疫组化均表达S-100、CD68以及Vimentin,不表达CK(AE1/AE3)、Desmin。结论乳腺颗粒细胞瘤非常少见,大部分为良性,且经手术切除后预后均良好,恶性极其少见,但影像学检查、冰冻切片以及穿刺标本非常容易误诊为恶性肿瘤。Objective To explore the clinicopathological characteristics,diagnosis,differential diagnosis,treatment and prognosis of granular cell tumor(GCT)of the breast,to review relevant literature,and to improve the understanding of this entity.Methods A retrospective review was conducted on 5 patients who underwent surgical resection and 1 patient who underwent consultation,all of whom developed granular cell tumor in the breast at the First Affiliated Hospital of Air Force Military Medical University from March 2014 to March 2022.Clinicopathological information of the patients was collected and analyzed.Results In 6 cases of breast GCT the large cells with round,oval,or polygonal in shape arranged in a nest like,cord like,or solid patchy pattern.The cytoplasm was rich with eosinophilic granules and the nucleus was small,round,centered and hyperchromatic.The nucleolus was not obvious,and no mitotic figures or tumor necrosis were observed.The tumor tissue was segmented by a large number of collagen fiber bundles of varying thickness.There was no obvious capsule around the tumor and the boundary was unclear.Tumor cells often grew infiltratively around the mammary ducts and lobules and were distributed around nerve bundles and blood vessels.In addition,tumor cells often infiltrated into the surrounding fibrous adipose tissue.The breast GCT expressed S-100,CD68 and Vimentin,but did not express CK(AE1/AE3)or Desmin.Conclusions Granular cell tumor of the breast is very rare.Most of them are benign and have a good prognosis after surgical resection,while malignancy is extremely rare.However,imaging examinations,frozen sections,and puncture specimens can easily be misdiagnosed as malignant tumors.

关 键 词：乳腺 颗粒细胞瘤 免疫组化 临床病理 

分 类 号：R737.9[医药卫生—肿瘤]