乳腺病例浅谈.pptxVIP

乳腺病例浅谈;一位84的老太太由于乳腺结节做了乳腺切除及腋窝淋巴结清扫，大体检查有2个结节，一个5x3.5，另一个直径2cm。 An 84 year old woman had a total mastectomy with axillary dissection for a breast nodule.? The main mass was 5 x 3.5 cm, and a 2 cm mass was nearby. ; ;第4页/共143页;第5页/共143页;第6页/共143页;What is your diagnosis?? ;;浸润性分泌性癌在乳腺癌中是一个不太常见的类型，约占所有乳腺癌的1-4%，在老年妇女中比浸润性导管癌更为常见。通常显示一个囊内结节，镜下，肿瘤由界限较清的细胞组成，具有颗粒状嗜伊红的细胞质，多具有泡状细胞核和明显的核仁和可以见到的猪嘴样的腺体，这种诊断仅限于具有明显顶浆分泌改变和明显恶性的肿瘤中。;Invasive apocrine carcinoma is an uncommon subtype of breast carcinoma, representing 1-4% of all carcinomas.? It typically affects older women than infiltrating ductal carcinoma (Breast Cancer 2002;9:43).? Grossly, it may present as a mural nodule within a cyst.? Microscopically, the tumors are composed of cells with distinct cell margins, eosinophilic cytoplasm and granules.? They have vesicular nuclei with prominent nucleoli, and may have glands with apocrine snouts.? This diagnosis should be limited to tumors with widespread apocrine change and obvious malignancy. ;Case of the Week #62;第12页/共143页;第13页/共143页;第14页/共143页;第15页/共143页;第16页/共143页;第17页/共143页;第18页/共143页;第19页/共143页;第20页/共143页;第21页/共143页;;硬化似乎开始于小叶的中央并向周围放射，腺泡周围纤维化明显，马氏三色染色可见小叶内纤维化，The sclerosis seemed to start at the center of the lobule and radiate towards the periphery, incarcerating the acini with severe fibrosis and atrophy (Figure 7, 8).? The Trichrome stain highlighted dense interlobular fibrosis and a peculiar periacinar sclerosis with a glomeruloid pattern (Figure 9, 10). The myoepithelial cells were prominent in these areas, as demonstrated by Calponin immunoreactivity (Figure 11);What is your diagnosis? ?;乳腺硬化性小叶增生Sclerosing lobular hyperplasia of the breast;硬化性小叶增生是一个不太常见的病变，多表现为小叶显蓍增生和小叶内间质的弥漫性纤维化，几乎均发生于年青女性，病人通常短期内可发生一个无痛性的??界较清的包块，此类病变首先被KOYI报道了18例，多发生于28-32的年龄。? ;Sclerosing lobular hyperplasia is an uncommon lesion of the female breast characterized by prominent hyperplasia of the lobules with severe and extensive fibrosis of the intralobular stroma, and to a lesser degree,