乳腺浸润性微乳头状癌临床病理学研究(附14例报道)

    Clinicopathological study of invasive micropapillary carcinoma of the breast:A report of 14 cases

    • 摘要: 目的:探讨乳腺浸润性微乳头状癌(IMPC)的临床病理特征和鉴别诊断。方法:观察14例IMPC临床病理资料、组织病理学形态和免疫表型。结果:14例IMPC无特殊的症状和体征,在乳腺浸润性导管癌中发生率为4.8%;其淋巴结转移阳性率78.6%及转移个数(平均7.6个)均明显高于浸润性导管癌(41.0%,平均3.5个)(P<0.05);组织病理学特征性表现为:癌巢呈假乳头状,由位于人工间隙内呈中空簇状/腺管状排列的瘤细胞构成;瘤细胞呈立方形或低柱状,胞质细颗粒状;核卵圆形,深染,有轻度异型性,分裂象较少。免疫表型:上皮膜抗原(EMA)在瘤细胞中有独特的阳性表达--"反极"染色现象,部分瘤细胞可表达ER、PR、c-erbB-2。结论:IMPC是乳腺癌中的少见类型,癌巢呈假乳头状,生物学行为恶性度较高,诊断时应与浸润性乳头状癌、黏液腺癌、转移性乳头状癌相鉴别。

       

      Abstract: Objective: To investigate the clinicopathological characteristics and differential diagnosis of invasive micropapillary carcinoma(IMPC) of the breast.Methods: The clinicopathologic information,histopathology and immunophenotype of 14 cases of IMPC of the breast were studied.Results: No special chinical symptoms or signs were observed in the cases.The occurrence of IMPC was 4.8%.The incidence of metastases of the lymph node(78.6%) and the number of metastatic node(on average 7.6) occurred more often in IMPC than that of the invasive ductal carcinoma(41.0%,on average 3.5).Histpathological features manifested that the nest of IMPC was pseudopapillary and was characterized by the tumor cells within artifical hollow space in clustered/tubular shape;the tumor cells were cylindercial or cubic,containing fine granular;the nucleus was oval,deep dyeing,mildly pleomorphic,and mitotic activity was rarely seen.Immunophenotype showed the toumor cells expressed an unique antistaining for epithelical membrance antigen(EMA),and part of the tumor cells expressed ER,PR or c-erbB-2.Conclusions: IMPC is a rare type of breast carcinomas,and its histopathologic feature is pseudopapillary nest of IMPC.The biological behaviour of IMPC is highly maliganant.More attentions should be paid to the differentiation of this tumor from invasive papillocarcinoma,mucinous carcinoma and metastatic carcinoma.

       

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