摘要
目的 探讨乳腺分泌基质的癌(MPC)的临床病理特征。方法 分析1例女性MPC患者的临床信息、组织形态以及免疫组化染色结果,并复习文献。结果 患者为70岁女性,左乳包块。组织学显示肿瘤组织为结节性生长,周围可见纤维性包裹,边缘有微浸润。镜下见浸润癌直接转化为黏液软骨样基质,浸润癌区域肿瘤细胞体积中等偏大,圆形、椭圆形,胞质嗜酸性或局部透亮,核圆形体积中等,异型性较明显,染色质淡,核膜清晰,核仁显著,核分裂易见。免疫组化显示肿瘤细胞Vim, CK5/6,S-100,p16(胞质),p53(胞核),E-cad(部分肿瘤细胞膜)均阳性,雌激素受体(ER)、孕激素受体(PR)、HER2、p63均阴性,Ki-67增殖指数约25%。二代测序检测证实肿瘤组织存在AUTS2-CNTNAP2基因融合。结合文献、形态学、免疫组化结果分析,并且与黏液癌、黏液性样囊性癌以及良性多形性腺瘤等相鉴别,诊断为乳腺分泌基质的癌。结论 MPC为一种罕见乳腺恶性肿瘤,好发于老年女性,形态学特征与多种乳腺良恶性病变容易混淆。需综合分析相鉴别。
Objective To investigate the clinicopathologic features of breast matrix-producing carcinoma(MPC). Methods The clinical information, histology and immunostaining of one case of female MPC were analyzed, and the literature was reviewed. Results The patient was a 70-year-old woman with a mass in her left breast. Histologically, the tumor showed nodular growth with fibrous encrustation and microinfiltration around the margin. Microscopically, the infiltrating carcinoma transformed directly into mucocartilaginous stroma. The tumor cells in the infiltrating area were medium to large in size, round and oval in shape, eosinophilic or partially transparent in cytoplasm, medium in size and round innucleus, with obvious atypia, the chromatin is pale, the nuclear membrane is clear, the nucleolus is remarkable, the mitosis is easy to seen. Immunostaining showed that tumor cells were positive for Vim, CK56, S-100, p16(cytoplasm), p53(nucleus), and E-cad(focal cell membrane), but negtive of estrogen receptor(ER), progesterone receptor(PR), HER2, and p63. The Ki-67 index is about 25%. Next generation sequencing confirmed the presence of AUTS2-CNTNAP2 gene fusion in tumor tissue. Based on the analysis of literature, morphology and immunohistochemistry, it was diagnosed as a matrix-producing carcinoma of the breast, which has been differentiated from mucinous carcinoma, mucoid cystic carcinoma and benign pleomorphic adenoma. Conclusion MPC is a rare malignant tumor of breast, which often occurs in elderly women. The morphological features of MPC are easily confused with various benign and malignant breast lesions. Comprehensive analysis is necessary for differential diagnosis.
作者
刘珊
胡红芳
程波
权兰菊
丁姗姗
孙锁柱
LIU Shan;HU Hong-fang;CHENG Bo;QUAN Lan-ju;DING Shan-shan;SUN Suo-zhu(Department of Pathology,Rocket Force Medical Center,Bejing 100088;Department of Research,Rocket Force Medical Center,Bejing 100088,China)
出处
《诊断病理学杂志》
2022年第11期1015-1018,共4页
Chinese Journal of Diagnostic Pathology
关键词
分泌基质的癌
乳腺化生性癌
三阴性乳腺癌
基因重排
上皮间质转化
Matrix-producing carcinoma
Metaplastic carcinoma of breast
Triple-negative carcinoma of breast
Gene rearrangement
Epithelial-mesenchymal transformation
