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目的产生基质的化生性乳腺癌(matrix-producing metaplastic carcinoma of the breast,MPMC)较罕见,病理形态非常特殊,容易导致误诊。本研究探讨MPMC临床病理学特征、诊断要点及鉴别诊断。方法收集2010-01-01-2016-01-01北京大学人民医院MPMC患者6例。患者均为女性,年龄42~73岁,中位年龄49岁。分析6例MPMC的临床特点,观察其组织病理学表现并进行免疫组化染色,同时复习相关文献资料。结果肿瘤呈结节状生长,部分区域呈浸润性生长方式。结节周围为大片上皮样巢团,中央为黏液软骨样基质,可见坏死。6例上皮样细胞团均为乳腺浸润性导管癌,4例组织学分级呈Ⅲ级改变,2例为Ⅱ级。免疫组化6例患者中有4例ER、PR和C-erbB-2阴性,1例ER阳性,1例C-erbB-2为+,6例CK5/6、S100、CK和Vimentin、EGFR阳性。另做组织化学染色AB-PAS,6例均为阳性。结论MPMC一种非常罕见的恶性肿瘤,诊断时需与叶状肿瘤等鉴别,免疫组化有助于鉴别诊断。
The purpose of matrix-producing metaplastic carcinoma of the breast (MPMC) is rare, pathological morphology is very special, easily lead to misdiagnosis. This study was to investigate the clinicopathological characteristics, diagnosis points and differential diagnosis of MPMC. Methods Six patients with MPMC from Peking University People ’s Hospital were recruited from January 1, 2010 to January 16, 2010. Patients were female, aged 42 to 73 years, mean age 49 years. The clinical features of 6 cases of MPMC were analyzed, their histopathological findings were observed and immunohistochemistry staining was performed, and relevant literature was reviewed. Results The tumors showed nodular growth and some regions showed invasive growth. Around the nodules for large epithelial nest, the central mucoid cartilage-like matrix, necrosis can be seen. Six cases of epithelial cell mass were invasive ductal carcinoma, histological grade was grade Ⅲ in 4 cases, grade Ⅱ in 2 cases. Four of the six immunohistochemical samples were negative for ER, PR and C-erbB-2, one was positive for ER, one was positive for C-erbB-2 and six were CK5 / 6, S100, CK and Vimentin . Another do histochemical staining AB-PAS, 6 cases were positive. Conclusion MPMC is a very rare malignant tumor, which needs to be differentiated from phyllodes tumor in diagnosis. Immunohistochemistry is helpful for the differential diagnosis.