《乳腺病例浅谈》PPT课件.ppt

Choose the correct diagnosis: a.?Myofibroblastoma肌纤维母细胞肿瘤 ?b.?Metaplastic carcinoma?化生性癌 c.?Phyllodes tumor叶状肿瘤 ?d.?Sarcoma肉瘤 You answered: Myofibroblastoma 这是一例边界较清的肿瘤,由伴有嗜酸性胞质的和细长的温和的梭形细胞组成,密集的,粘蛋白状胶原散在在梭形细胞之间,这些细胞缺少显著的非典型性,没有核分裂, 肿瘤细胞弥漫的CD34, desmin, estrogen 和PR阳性,但所有的上皮性表达阴性. Histology:This is a well delineated tumor composed of bland spindle cells featuring eosinophilic cytoplasm and tapered nuclei. Dense, ropy collagen is interspersed between the spindle cells. The cells lack significant atypia, and mitosis are not apparent. Tumor cells are diffusely immunoreactive for CD34, desmin, estrogen receptor, and progesterone receptor, but negative for all epithelial markers. 化生性癌不表达CD34,而表达CK,化生性癌会伴有鳞状分化,叶状肿瘤典型的会有浸润性边界,且会伴有良性的上皮,乳腺原发性肉瘤罕见,但会见到细胞的多形性,核分裂像和坏死,肌纤维母细胞肿瘤更多见于男性,肌纤维母细胞肿瘤形态学与假血管肉瘤样增生相似,故也称为肌样错构瘤,肌纤维母细胞肿瘤若缺少肌源性分化与孤立性纤维性肿瘤相似。 Discussion:A metaplastic carcinoma would not label for CD34, and would label for cytokeratins. Metaplastic carcinomas typically show variable cellularity along with squamous differentiation. Phyllodes tumor would feature a benign epithelial component within the lesion, and typically has an infiltrative border. Primary sarcomas of the breast are uncommon, but typically feature spindle cells with pleomorphism, mitotic activity, and associated necrosis. Myofibroblastomas are more common in males than females. Myofibroblastomas are morphologically similar to pseudoangiomatous hyperplasia, and may be related to so-called myoid hamartoma. Myofibroblastomas which have lost their muscular differentiation may resemble solitary fibrous tumor. Week 288: Case 5 12岁女性单侧乳腺增大并累及到腋窝 Clinical History:This 12 year-old girl developed unilateral breast enlargement that extended in the axilla. Choose the correct diagnosis: a.?Fibroadenoma?纤维腺瘤 b.?Juvenile hypertrophy幼年性乳腺肥大 ?c.?Ductal adenocarcinoma导管腺癌 ?d.?Gynecomastia 男子女性型乳腺? You answered: Juvenile hypertrophy 从腋窝切除的乳腺组织显示了管状结构伴有突出的间质成分,但没有小叶结构. Histology:The breast tissue resected from the ax