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患者,女,40岁。以右乳房肿块3年,迅速增大3个月于1990年7月7日入院。查体:右乳房皮肤光滑,无桔皮样改变,乳头无凹陷及溢液,外上象限触及一约4cm×3cm大小肿块,质地较硬,呈结节状,边界清楚,推之可动,无触痛。全身浅表淋巴结未触及。肿块细针穿刺活检见有恶性瘤细胞。临床诊断右乳腺癌,行右乳癌根治术。大体标本可见:肿瘤大小4cm×3.5cm×3cm,扁圆形,呈结节状,境界清,质地较硬,切面灰白色,见有纤细条纹,部分呈旋涡状。镜下见:瘤细胞长梭形束状排列,纵横交错,部分区域分化差,见少数瘤巨细胞,短梭形细胞,多边形细胞,最多每个高倍视野见6个核分裂像。VG染色瘤细胞(+),SAM(+),Myoglbin(-),S—(?)蛋白(?)腋下淋巴结未见转移癌(0/17)。术后病理诊
Patient, female, 40 years old. With a right breast mass for 3 years, she was rapidly enlarged for 3 months and admitted to hospital on July 7, 1990. Physical examination: The skin of the right breast was smooth, there was no change in orange peel, there was no depression and discharge in the nipple, and the upper quadrant touched a mass of about 4cm×3cm in size. The texture was hard, nodular, the boundary was clear, and the push was movable. No tenderness. Whole body superficial lymph nodes are not touched. Fine needle needle biopsy showed malignant cells. Clinical diagnosis of right breast cancer, right breast cancer radical surgery. Gross specimens can be seen: tumor size 4cm × 3.5cm × 3cm, oblate, nodular, clear boundary, hard texture, gray cut surface, see the thin stripes, some whirlpool. Seen under the microscope: The long spindles of the tumor cells are arranged in a bundle, criss-cross, and some areas are poorly differentiated. See a few tumor giant cells, short spindle cells, polygonal cells, and see at most 6 mitoses in each high-power field. VG stained tumor cells (+), SAM (+), Myoglbin (-), S-(?) Protein (?) No metastatic carcinoma of the axillary lymph node (0/17). Postoperative pathology diagnosis