摘要
目的增加对乳头区Paget病(paget disease of the nipple region,PDNR)临床特征和组织病理学特点的认识。方法回顾性分析成都三家医院在2017-06—2020-06间诊治的10例PDNR患者的临床和病理资料。结果10例PDNR患者均为女性,发病年龄43~72岁,平均发病年龄(60.89±8.78)岁,中位病程6个月(病程范围1个月~3年)。以单侧乳头和(或)乳晕皮肤病变或发现乳腺包块发病,左侧与右侧比例一致。组织病理特征:患者均出现典型增生模式,其次以棘层分解模式多见。Paget细胞体积大、胞质淡染丰富、核大,核仁明显,偶见核分裂象。表皮增生方式分别为假癌性增生(100%),伴银屑病样增生(40%),伴Pinkus样纤维上皮瘤样增生(20%)。8例患者伴导管原位癌,其中4例有浸润。免疫组化CK7、CK8、广谱CK(+);CEA、GCDFP-15部分(+);HMB45 S-100 CK5/6、p63(-)。结论乳头区Paget病是一种少见乳腺恶性肿瘤,有独特的组织学特点,预后良好。
Objective To investigate the clinical and histopathological features of Paget disease of the nipple region(PDNR). Methods The clinical and pathological data of 10 patients with PDNR from June 2017 to June 2020 in three hospitals of Chengdu were retrospectively analyzed. Results All the 10 patients were female. The average age of onset was(60.89 ± 8.78) years. The median course of disease was 6 months(range from 1 month to 3 years). The incidence of the disease was unilateral nipple and/or areola skin lesions or breast masses. The ratio of left side to right side was the same. Histopathological study showed that typical pattern was found in all patients, followed by acantholysis-like pattern. Paget cells were large in size, rich in cytoplasmic staining, a large nucleus, with obvious nucleoli, and occasionally with mitotic figures. The types of epidermal hyperplasia were pseudocarcinomatous hyperplasia(100%), psoriasis-like hyperplasia(40%) and Pinkus-like fibroepithelioma(20%). Eight patients were accompanied with ductal carcinoma in situ, of which 4 had invasion. Immunohistochemistry showed that CK7, CK8 and broad-spectrum CK were positive;CEA and GCDFP-15 were partially expressed;HMB45, S-100, CK5/6, p63 were negative. Conclusion Paget’s disease of the nipple region is a rare malignant breast tumor with unique histological characteristics and good prognosis.
作者
吕春燕
唐艳
苏倩瑶
程宵
尔过阿牛木
程显魁
彭秋菊
LV Chun-yan;TANG Yan;SU Qian-yao;CHENG Xiao;Er Guo-a-niu-mu;CHENG Xian-kui;PENG Qiu-ju(Chengdu University Basic Medical School,Chengdu 610106,China;Department of Pathology,Chengdu Third People’s Hospital,Chengdu 610014,China;Department of Pathology,the Affiliated Provincial Hospital of Shandong First Medical Unirersity,Jinan 250021,China)
出处
《诊断病理学杂志》
2021年第8期618-621,630,共5页
Chinese Journal of Diagnostic Pathology
关键词
乳头区
PAGET病
临床病理分析
Papillary region
Paget’s disease
Clinicopathological analysis
