摘要
目的探讨乳腺恶性腺肌上皮瘤(adenomyoepithelioma,AME)的临床及病理学特点、诊断及鉴别诊断。方法运用HE染色、镜检及免疫组化染色对3例AME进行临床病理学分析,并复习相关文献。结果肿瘤主要形态特征是由肌上皮围绕腺上皮构成的管腔所形成的双层套管结构。2种上皮有不同程度的增生,呈巢团状。肿块呈浸润性生长,细胞异型性明显,核分裂多见。免疫组化表达结果具有双相性,腺上皮表达CK8、CK18、EMA等,肌上皮表达SMA、S-100、p63等。肿瘤细胞ER、PR、Her-2阴性,CK5/6和(或)EGFR有不同程度的阳性表达,具有基底样型乳腺癌的免疫表型。结论恶性AME十分罕见,应与乳腺肌上皮癌、化生癌、肉瘤等多种肿瘤相鉴别,其组织学特点及免疫组化表型是诊断的关键。
Purpose To investigate the clinical and pathological features,diagnosis and differential diagnosis of malignant adenomyoepithelioma of the breast.Methods Morphological observation of the HE-stained sections and immunohistochemistry were applied in 3 cases of malignant adenomyoepithelioma of the breast,and the related literatures were reviewed.Results The key morphological feature of the lesion was double-layer tubular pattern composed of glandular epithelial and myoepithelial cells.The glandular epithelial cells were located in the inner layer of the tubular pattern,arranging in glandular lumen,while the myoepithelal cells were located in the outer layer.The both proliferative cells arranged in nests or clusters,growing infiltratively,with frequent mitoses and atypia.The immunostaining showed biphasic patterns.The glandular epithelial cells were positive for CK8,CK18 and EMA,while the myoepithelial cells were positive for SMA,S-100,p63 etc.The both cells were negative for ER,PR and Her-2 and positive for CK5/6 and/or EGFR,the same immunophenotype of basal-like breast cancer.Conclusions Malignant adenomyoepithelioma of the breast is a rare neoplasm,which is easily confused with myoepithelial carcinoma,metaplastic carcinoma,sarcoma,and others.The morphological features and immunophenotype are helpful in the differential diagnosis.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2011年第8期838-842,共5页
Chinese Journal of Clinical and Experimental Pathology
关键词
乳腺肿瘤
恶性腺肌上皮瘤
组织学
免疫组织化学
诊断
breast neoplasms
malignant adenomyoepithelioma
morphology
immunohistochemistry
diagnosis
