乳腺恶性叶状肿瘤6例临床病理剖析.docVIP

乳腺恶性叶状肿瘤6例临床病理剖析 　　[摘要] 目的 探讨乳腺恶性叶状肿瘤的临床病理特点、诊断、鉴别诊断及治疗。方法 收集2009~2013年东莞市人民医院及东莞市莞城人民医院收治的6例乳腺恶性叶状肿瘤，对其临床病理资料进行回顾性分析。 结果 4例患者确诊恶性前有多次手术治疗史及复发史，2例为首诊。末次手术乳腺区段切除1例，单纯乳腺全切除加前哨淋巴结探查2例，改良根治术3例；术后化疗2例，术后双肺转移及死亡1例，其余5例术后随访5个月~4年无复发和转移。结论 乳腺恶性叶状肿瘤诊断主要依据病理学，免疫组化具有一定的辅助作用和鉴别诊断作用。大部分由良性或交界性反复复发后恶变，手术切除为主要治疗方式，手术切除范围和复发有一定关系。 　　[关键词] 乳腺叶状肿瘤；恶性叶状肿瘤；病理；临床特点 　　[中图分类号] R737.9[文献标识码] B[文章编号] 1673-9701（2014）16-0090-03 　　 　　Clinicopathological analysis of 6 cases of m alignant phyllodestumors of the breast 　　LUO Rong LI Lin WU Jiayu 　　Department of Pathology， Guancheng Hospital of Dongguan City， Dongguan523008，China 　　[Abstract] Objective To investigate the clinicopathological features， diagnosis， differential diagnosis and treatment of m alignant breast phyllodes tumors. Methods We collected the data of the 6 cases of m alignant breast phyllodes tumors admitted in Dongguan People’s Hospital and Guancheng Hospital from 2009 to 2013 and analyzed retrospectively their clinicopathological data. Results 4 cases with definite diagnosis of m alignancy underwent multiple surgical treatments and relapses， and 2 cased were diagnosed the first time. In the last surgery， 1 case underwent segmental mastectomy； 2 cases underwent total mastectomy with exploration of sentinel lymph nodes； 3 cased underwent modified radical surgery. 2 cases were treated with postoperative chemotherapy. 1 case died of postoperative metastasis to bilateral lungs. The balance 5 cases had no relapses or metastasis during the postoperative follow-up of 5 months to 4 years.Conclusion M alignant breast phyllodes tumors were diagnozed mainly on basis of pathology and immunohistochemisty helped in diagnosis and differential diagnosis. Most m alignancies resulted from repeat relapses of benign or borderline breast tumors. Surgical resection was the main treatment. Resection extent related to relapses. 　　[Key words] Breast phyllodes tumor； M alignant phyllodes tumor； Pathology； Clinic features乳腺叶状肿瘤是一组界限清楚的双向分化的肿瘤，是一