摘要
目的探讨乳腺恶性腺肌上皮瘤的病理形态学特点、诊断及鉴别诊断。方法应用光镜观察及免疫组化染色方法对1例乳腺恶性腺肌上皮瘤进行临床病理分析,并复习文献。结果肿瘤由恶性腺上皮和肌上皮两种细胞组成,呈巢团状浸润于增生的纤维间质中 腺上皮胞质红染,位于肿瘤细胞巢中央,排列呈腺管状 肌上皮围绕腺上皮排列于肿瘤细胞巢的周边,胞质透明,核分裂多见,细胞异型明显。免疫组化具有双向性表达特征,两种上皮CK5/6均（＋）,腺上皮CK8/18和34βE12（＋）,肌上皮p63和SMA（＋）。结论乳腺恶性腺肌上皮瘤罕见,预后差,与浸润性导管癌、化生性癌、肉瘤等多种肿瘤易混淆 应依据形态学特点、结合免疫组化结果鉴别。
Objective To investigate the pathological features, diagnosis and differential diagnosis of malignant adenomyoepithelioma in the breast. Methods Morphological observation and immunohistochemistry were applied in one case of malignant adenomyoepithelioma of the breast, and the literatures were also reviewed. Results Typical lesions, arranging in nests or clusters, were composed of malignant glandular epithelium and myoepithelial cells, infdtnting in the fibrous stroma. The glandular epitheha with eosinophilie cytoplasm were located in the center of the nests, arranging in glandular lumen, which were seen as dark cells. The myoepithelia with transparent cytoplasms were located around the lumens, with frequent mitoses and atypia, which were seen as clear ceils. The immunostaining showed biphasie patterns. The both types were expressed with CK5/6, and epithelial cells with CK8/18 and 34β3E12, while myoepithelial cells were positive for 1363 and SMA. Conclusion Malignant adenomyoepithelioma of the breast is a rare neoplasm with poor prognosis, which is easily confused with infiltrating ductal carcinoma, metaplastic carcinoma or sarcoma and others, and immunohistochemistry helps in the diferenfial diagnosis, combined with morphologicl features.
出处
《诊断病理学杂志》
CSCD
2009年第3期177-180,共4页
Chinese Journal of Diagnostic Pathology
关键词
乳腺
恶性腺肌上皮瘤
形态
免疫表型
鉴别诊断
Breast
Malignant adenomyoepithelioma
Morphology
Immunohistochemical phenotype
Differential diagnosis
