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目的探讨乳腺腺样囊性癌(BACC)临床病理特点、免疫组化及鉴别诊断。方法观察8例BACC组织形态、免疫组化特点并收集相关临床资料,结合文献进行分析。结果 8例BACC均为女性,年龄49~77岁,平均年龄59.8岁;肿块位于左侧乳腺2例,右侧乳腺6例,均靠近乳头。肿块界清,切面灰白或灰黄色。镜下肿瘤组织呈浸润性生长,呈筛状、管状-小梁状和实体型结构。瘤细胞由腺上皮细胞、肌上皮-基底样细胞构成。免疫组化:腺上皮细胞CK7、CK5、CK5/6、Cam5.2、EMA和CD117(+)。肌上皮-基底样细胞CK5、CK5/6、CK14、CK34βE12、p63、SM-MHC、calponin和S-100(+)。8例中1例瘤细胞PR弱(+),其余均(-),1例ER呈(+)、2例ER显示局灶(+),2例Her-2(2+)、3例(1+)。本组除1例为穿刺标本外,3例行乳腺改良根治术,均无腋下淋巴结转移;3例行患侧乳腺切除术;1例行局部扩大切除。术后经6~72个月随访均无复发及转移。结论 BACC是一种罕见的低度恶性肿瘤,具有独特的组织病理学特征及免疫表型,很少发生淋巴结转移,预后好。
Objective To investigate the clinicopathological features, immunohistochemical and differential diagnosis of breast adenoid cystic carcinoma (BACC). Methods 8 cases of BACC histomorphology, immunohistochemical characteristics and collection of relevant clinical data, combined with the literature analysis. Results 8 cases of BACC were female, aged 49 to 77 years, mean age 59.8 years; mass in the left breast in 2 cases, 6 cases of right breast, all close to the nipple. Mass clearance, cut gray or gray. Microscopic tumor tissue was invasive growth, was sieved, tubular - trabecular and solid-type structure. Tumor cells are composed of glandular epithelial cells and myoepithelial-basal-like cells. Immunohistochemistry: glandular epithelial cells CK7, CK5, CK5 / 6, Cam5.2, EMA and CD117 (+). Myoepithelial-basal cells CK5, CK5 / 6, CK14, CK34βE12, p63, SM-MHC, calponin and S-100 (+). One of the eight cases had a weak PR (+), the rest were (-), one was ER (+), two ER was focal (+), two Her-2 1+). In addition to a puncture in this group of specimens, 3 patients underwent modified radical mastectomy, no axillary lymph node metastases; 3 cases of ipsilateral mastectomy; 1 case of local expansion. No recurrence and metastasis occurred after 6 to 72 months of follow-up. Conclusions BACC is a rare low-grade malignant tumor with unique histopathological features and immunophenotype. It is rare for lymph node metastasis and has a good prognosis.