Although it is generally recognized that some benign sweat gland neoplasms may show appreciable mitotic activity, there are few reports of its quantitative analysis in specific tumor types or of its correlation with c...Although it is generally recognized that some benign sweat gland neoplasms may show appreciable mitotic activity, there are few reports of its quantitative analysis in specific tumor types or of its correlation with clinical behavior. The presence of a large number of mitoses in a sweat gland tumor for which the histologic criteria ofmalignancy are not well defined, particularly in association with nuclear abnormalities, may produce a considerable diagnostic challenge. We recently encountered such a problem in a putative case of hidradenoma papilliferum. Therefore, we have undertaken a retrospective clinicopathologic study of 19 cases originally diagnosed as hidradenoma papilliferumor probable hidradenoma papilliferum, with a particular emphasis on the relationship of the mitotic index to clinical behavior.The age range of the cases was 41 to 92 years (mean 56.8 years). In all cases in which the margins could be evaluated, the tumors were well circumscribed (15/15), but in 4 cases circumscription could not be assessed because the specimen was fragmented. All showed focal mild nuclear pleomorphism. Mitoses were present in both epithelial and myoepithelial cells. The mitotic index varied from 0 to 5.3 mitoses/mm (0 to 13 mitoses per 10 high power fields (hpf); 1 hpf≤0.246 mm), with a mean of 2.4/mm (6/10 hpf) and a median of 0.8/mm (2/10 hpf). No atypical mitoses were identified. The proliferative fraction (MIB-1 index) correlated with the mitotic index (correlation coefficient 0.94; P< 0.0001) and varied from 1%to 10.5%(mean 3.9%, median 3.0%). There were no recurrences or metastases over a mean period of 8 years. Consequently, we have shown that the mitotic index in these lesions can be variable and often high, but it does not predict a more aggressive outcome.展开更多
子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌...子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌,由簇状或小巢团状肿瘤细胞组成,缺乏纤维血管轴心,与周围组织存在空隙,异型性明显;在免疫组织化学染色中显示特征性的黏蛋白1外缘染色和E-钙黏蛋白杯状染色。肿瘤浸润前沿同时可见MELF浸润方式。肿瘤浸润深肌层,可见脉管癌栓和1枚淋巴结隐匿性癌转移。患者术后接受化学治疗和放射治疗,恢复良好,随访53个月无复发或转移。临床上此类病例具有高侵袭性的生物学行为,容易漏诊,需要予以重视。展开更多
文摘Although it is generally recognized that some benign sweat gland neoplasms may show appreciable mitotic activity, there are few reports of its quantitative analysis in specific tumor types or of its correlation with clinical behavior. The presence of a large number of mitoses in a sweat gland tumor for which the histologic criteria ofmalignancy are not well defined, particularly in association with nuclear abnormalities, may produce a considerable diagnostic challenge. We recently encountered such a problem in a putative case of hidradenoma papilliferum. Therefore, we have undertaken a retrospective clinicopathologic study of 19 cases originally diagnosed as hidradenoma papilliferumor probable hidradenoma papilliferum, with a particular emphasis on the relationship of the mitotic index to clinical behavior.The age range of the cases was 41 to 92 years (mean 56.8 years). In all cases in which the margins could be evaluated, the tumors were well circumscribed (15/15), but in 4 cases circumscription could not be assessed because the specimen was fragmented. All showed focal mild nuclear pleomorphism. Mitoses were present in both epithelial and myoepithelial cells. The mitotic index varied from 0 to 5.3 mitoses/mm (0 to 13 mitoses per 10 high power fields (hpf); 1 hpf≤0.246 mm), with a mean of 2.4/mm (6/10 hpf) and a median of 0.8/mm (2/10 hpf). No atypical mitoses were identified. The proliferative fraction (MIB-1 index) correlated with the mitotic index (correlation coefficient 0.94; P< 0.0001) and varied from 1%to 10.5%(mean 3.9%, median 3.0%). There were no recurrences or metastases over a mean period of 8 years. Consequently, we have shown that the mitotic index in these lesions can be variable and often high, but it does not predict a more aggressive outcome.
文摘子宫内膜样癌伴有微乳头结构和微囊、伸长及碎片状(microcystic, elongated and fragmented,MELF)浸润者罕见。常州市第二人民医院收治1例52岁的女性子宫内膜样癌患者,其病理标本中出现了微乳头结构,微乳头形态类似乳腺浸润性微乳头状癌,由簇状或小巢团状肿瘤细胞组成,缺乏纤维血管轴心,与周围组织存在空隙,异型性明显;在免疫组织化学染色中显示特征性的黏蛋白1外缘染色和E-钙黏蛋白杯状染色。肿瘤浸润前沿同时可见MELF浸润方式。肿瘤浸润深肌层,可见脉管癌栓和1枚淋巴结隐匿性癌转移。患者术后接受化学治疗和放射治疗,恢复良好,随访53个月无复发或转移。临床上此类病例具有高侵袭性的生物学行为,容易漏诊,需要予以重视。