乳腺原发性腺泡细胞癌3例临床病理及文献复习  

Clinicopathological reports and literature review of 3 cases of primary acinar cell carcinoma of the breast

作　　者：范春华 夏云 Fan Chunhua;Xia Yun(Department of Pathology,the Third Hospital of Nanchang,Nanchang 330000,China)

机构地区：[1]南昌市第三医院病理科,南昌330000

出　　处：《实用医技杂志》2025年第4期290-293,I0003,共5页Journal of Practical Medical Techniques

摘　　要：目的探讨乳腺腺泡细胞癌的临床病理学特征,并复习文献,为乳腺腺泡细胞癌的临床诊疗提供参考。方法回顾2023年1月至2024年7月南昌市人民医院诊治的3例乳腺腺泡细胞癌的临床病理资料,根据患者的病理表现,诊治过程,结合文献对该疾病的临床特征和治疗后随访结果进行分析。结果乳腺腺泡细胞癌的组织学形态多样,多呈微腺样、管状、囊样结构浸润间质生长,其内可见嗜酸性分泌物,1例病例可见实性、条索状结构;肿瘤细胞胞质丰富,噬双色或空泡状,核圆形,核仁明显;1例病例伴有淋巴细胞多灶聚集。免疫表型:3例病例肿瘤细胞雌激素受体(ER)、人表皮生长因子受体(HER)-2均为阴性,2例孕激素受体(PR)阴性,1例PR(20%+),3例病例α1-抗胰糜蛋白酶和溶菌酶均弥漫强阳性,肌上皮标记物及CollagenⅣ均为阴性,Ki-67增殖指数40%~70%。结论乳腺腺泡细胞癌基因突变与三阴性乳腺癌高度重合,提示乳腺腺泡细胞癌可能是更具有侵袭性的TNBC前体,其诊断依赖组织学形态及免疫组织化学检查。Objective To investigate the clinicopathological features of acinic cell carcinoma of the breast,and to review the literature to provide reference for the clinical diagnosis and treatment of acinic cell carcinoma of the breast.Methods The clinicopathological data of 3 patients with breast acinic cell carcinoma diagnosed and treated in Nanchang People′s Hospital from January 2023 to July 2024 were reviewed,and the clinical characteristics and post-treatment follow-up results of the disease were analyzed according to the pathological manifestations and diagnosis and treatment process of the patients.Results The histological morphology of breast acinic cell carcinoma was diverse,mostly microadenoidal,tubular and cyst-like structures infiltrating interstitial growth,and eosinophilic secretions could be seen in it,and solid and cord-like structures were seen in one case,and tumor cells were rich in cytoplasm,bichromatic or vacuole-like,with round nucleus and obvious nucleoli.One case was accompanied by multifocal aggregation of lymphocytes.Immunophenotype:tumor cells in 3 cases were negative for ER and HER-2,2 cases were PR negative,1 case was PR(20%+),α1-antichymotrypsin and lysozyme were diffuse and strong positive in 3 cases,myoepithelial markers and CollagenⅣwere negative,and the Ki-67 value-added index was 40%~70%.Conclusion Breast acinic cell carcinoma gene mutation is highly overlapping with triple-negative breast cancer(TNBC),suggesting that breast acinic cell carcinoma may be a more aggressive TNBC precursor.

关 键 词：乳腺肿瘤 癌 腺泡细胞 病理学 临床 预后 

分 类 号：R737.9[医药卫生—肿瘤]