摘要
目的探讨一例罕见同时性双侧原发性乳腺癌(simultaneous bilateral primary breast cancer,SBPBC)的临床病理学特征。方法分析武汉大学人民医院2019年收治的一例SBPBC的临床病理资料,通过常规HE染色、应用HE染色及免疫组织化学分析其病理学特征及免疫组织化学表型,并复习相关文献。结果患者女,48岁,发现双乳肿块5天入院。双侧肿块大小约为1.0×1.0cm,界限欠清楚,切面灰白。镜下组织病理学特征为肿瘤细胞突破反应性间质区域,浸润至乳腺间质,大部分肿瘤细胞呈索状,簇状,部分肿瘤细胞呈微乳头状排列,大小不等,与周围间质裂隙状分隔,裂隙透亮,微乳头状缺乏纤维血管轴心,细胞质较丰富,细胞核级别中-高级别,另外可见导管原位癌成分,穿插于微乳头结构中。双侧乳腺组织免疫组化结果相同,均显示ER(+,约90%),PR(+,约70%),HER-2(1+),Ki67(+,约20%),P120(膜+)(图4),CK5/6(-),E-Cadherin(+),D2-40(淋巴管+)。结论双侧乳腺浸润性乳头状癌较为罕见,预后较差,血道、淋巴结转移率高,其特征性的病理组织学形态、免疫组织化学表型有助于诊断和鉴别诊断。
Objective To investigate the clinicopathologic features of a rare simultaneous bilateral primary breast cancer (SBP-BC) case.Methods The clinicopathological data of one patient with SBPBC from Renmin Hospital of Wuhan University was analyzed.The pathological features and immunohistochemical phenotypes were observed by light microscopy,and then relative literature was reviewed.Results The case was female,48 years old,and admitted to hospital 5 days after finding a mass in both breasts.The bilateral masses were both about 1.0×1.0cm in size,poorly demarcated,and showed a soft,lobulated,white to tan appearance.Microscopically,tumor cells break through the reactive interstitial area and infiltrate into the stroma of the breast.Most of the tumor cells are arranged in cord or cluster manners,and part of the tumor cells are arranged in a micropapillary manner with various sizes.The micropapillae are separated from the surrounding interstitium in a cleft form,and the clefts look lucency transparent.The micropapillae are lack of fiber axis of blood vessels.The cytoplasm is rich,and the nuclei are in middle to high nuclear levels.Ductal carcinoma in situ structures are also seen interspersed within the micropapillary structures.Immunohistochemical results of the bilateral breast tissues are the same,all show ER (+,90%),PR (+,70%),HER-2 (1+),Ki67 (+,20%),P120 (membrane+),CK5/6 (-),E-Cadherin (+) and D2-40 (+).Conclusion Simultaneous bilateral primary breast cancer has a relatively low incidence,poor prognosis,and high probability of blood or lymph node metastasis.Its characteristic histopathological morphology and immunohistochemical phenotypes are helpful for diagnosis and differential diagnosis.
作者
王登
阚艳芳
李艳
袁静萍
Wang Deng;Kan Yanfang;Li Yan;Yuan Jingping(Department of Pathology,Renmin Hospital of Wuhan University,Wuhan,430060,China;Department of Pathology,Central hospital of EnShi,EnShi,445000,China;Department of Pathology,Renmin Hospital of Tongshan county,Xianning,437600,China)
出处
《中国组织化学与细胞化学杂志》
CAS
CSCD
2021年第2期178-181,共4页
Chinese Journal of Histochemistry and Cytochemistry
基金
武汉市科技计划项目(2017060201010172)
武汉大学人民医院引导基金(RMYD2018M27)。
关键词
双侧乳腺浸润性乳头状癌
病理学特征
免疫组织化学
Simultaneous bilateral primary breast cancer
pathological characteristics
immunohistochemistry
作者简介
王登,男(1986年),土家族,住院医师;通讯作者:袁静萍,yuanjingping2003@aliyun.com。
