乳腺腺样囊性癌临床病理剖析并文献复习.docVIP

乳腺腺样囊性癌临床病理剖析并文献复习 　　【摘要】 目的：探讨乳腺腺样囊性癌的临床表现、病理特征及鉴别诊断要点。方法：对本院2009-2014年诊治的3例乳腺腺样囊性癌进行回顾性分析，观察其组织学特点并行免疫组化检测，结合相关文献复习。结果：3例乳腺腺样囊性癌患者临床表现为伴或不伴有疼痛的乳腺单发肿块。该肿瘤在组织结构上可以分为小梁-小管状、筛状及实体状三种类型，并需与一系列乳腺良恶性病变相鉴别，如胶原小体病、浸润性筛状癌、小管癌等。结论：乳腺腺样囊性癌是一种少见的特殊类型的乳腺癌，具有其独特的组织病理学特点，预后较好。 　　【关键词】 乳腺肿瘤； 腺样囊性癌； 病理学； 免疫组织化学； 临床 　　Clinical Pathological Analysis and Review of Literature of Adenoid Cystic Carcinoma of the Breast/SUN Li-xia，LI Rong-gang，LIAO Yue-hua，et al.//Medical Innovation of China，2016，13（09）：033-036 　　【Abstract】 Objective：To investigate the clinical manifestations，pathological features and differential diagnosis of the adenoid cystic carcinoma of the breast.Method：Three cases of the breast adenoid cystic carcinoma treated in our hospital during 2009 to 2014 were retrospectively analyzed，the histological characteristic was observed and immunohistochemical representations was detected and combined with the review of related literatures.Result：The main clinical presentation of all three cases was single mass which presenting occasionally painful.Three basic patterns were trabecular-cribriform，tubular and solid.The tumor should be distinguished from a series of benign and malignant breast diseases，such as collagenous spherulosis，invasive cribriform carcinoma，tubular carcinoma and so on.Conclusion：Adenoid cystic carcinoma of the breast is a rare neoplasm with distinctive histology and excellent prognosis. 　　【Key words】 Breast neoplasms； Adenoid cystic carcinoma； Pathology； Immunohistochemistry； Clinical 　　First-author’s address：The Central Hospital of Jiangmen City，Jiangmen 529030，China 　　doi：10.3969/j.issn.1674-4985.2016.09.009 　　乳腺腺样囊性癌（adenoid cystic carcinoma，ACC）是一种具有低度侵袭潜能的恶性肿瘤，不足乳腺癌总数的0.1%[1-2]，其组织学特征与唾液腺的同类肿瘤相似。乳腺腺样囊性癌极少发生淋巴道转移，预后极佳。据美国Connecticut肿瘤登记机构报告，大约有50%的病例为误诊。现收集本院2009-2014年收治的3例腺样囊性癌患者的资料，并结合文献复习，总结该病的临床及病理特点，以提高对该肿瘤的认识。 　　1 资料与方法 　　1.1 一般资料 本组患者3例，均为女性，年龄55～61岁，中位年龄57岁。自然病程1.3～120个月。2例患者为左乳肿块，1例为右乳肿块，临床均表现为乳腺单发肿块，质硬，活动度欠佳，其中1例伴阵发性针刺样疼痛并皮肤轻度红肿皲裂。2例患者行乳腺