乳腺伴梭形细胞化生腺癌2例及文献复习.pdfVIP

维普资讯 · 28 · lI盏床与实验病理学杂志 JClinExpPathol2005Feb；21(1) 乳腺伴梭形细胞化生腺癌 2例及文献复习 卢洪胜，郑晓刚，孟 奎，吴 波，石群立 [摘要] 目的 探讨乳腺伴梭形细胞化生腺癌的临床病理特点及鉴别诊断要点。方法 复习2例乳腺伴梭形细胞化生腺癌 的临床资料，并行免疫组化标记。结果 组织学特点：癌组织由梭形细胞构成，细胞异型不明显，核分裂象不多，呈片巢状、条 索状、编织状排列，梭形细胞 内可见腺癌的管状成分。免疫组化染色显示：癌细胞呈上皮性免疫表型，CK(pan)、EMA阳性， ER、PR、c—erbB一2常阴性，不表达S-100蛋白、desmin和vimentin。结论 乳腺伴梭形细胞分化的腺癌是上皮性特殊性乳腺癌中 乳腺化生性癌的 1种，其诊断主要依靠组织病理学及免疫组化标记。 [关键词】 乳腺肿瘤；化生性癌；梭形细胞分化；腺癌；免疫组织化学 [中图分类号] R7379 [文献标识码] A [文章编号] 1001—7399(2005)01—0028—04 Adenocarcirtomawithspindlecellmetaplasiaofthebreast：areportoftwocasesandreview oftheliterature LUHong—sheng，ZHENGXiao—gang，MENGKui，WUBo，SHIQun—li (DepartmentofPathology，NanfingGeneralHospitalofNanjingMilitaryCommand，Nanfing 210002，China) [Abstract] Purpose Toinvestigatetheclinicalpathologiccharacteristicsofadenocracinomawithspindlecellmetaplasia(ASCM) ofthebreast．M ethods TwocasesofASCM ofthebreastwerestudiedbyclinicaldata，lightmicroscopyand immunohistochemistry． Results Onecaseoccurredina69一year·oldfemale，anotherWasa49一yera—oldfemale．Morphologically，thetumorcellswerecomposed wiht spindlecells，andthecellulra pleomorphism Was notobvious，themitoticfiguresWas rare Thetumorexhibitedsolid—neststreak， ， steriform patterns，andusuallyincluded theelementoftheductual cracinomasofthebreast．Immunohistochemically，thetumorcells weresrtonglypositiveforCK(pan)、EMA，negetiveofrER、PR、C—erbB一2ingeneral，andobviouslynegetiveofrS-100、desmin、vimen— tin．Conclusions ASCM ofthebreastisaspecialtypeofmammarycracinoma．Thediagnosisofthetumormainlydependsonhistopa— thologynadimmunohistochemistry． [Keywords] breastneoplasms；metaplasticcracinomas；spindlecellmetaplasia；adenocracinoma；immunohistochemistry 乳腺伴梭形细胞化生的腺癌 ¨(adenocarcinoma cm包块，质偏硬，表面不光滑，边界不清，与表面皮 withspindlecellmetaplasia，ASCM)是2003年 WHO 肤有明显粘连，推之不动，无压痛，伴乳头变形、凹