乳腺伴神经内分泌分化及反应性肉芽肿的组织细胞-肌母细胞样癌

Histiocytoid-myoblastomatoid breast carcinoma with responsive granuloma and neuroendocrine differentiation

目的 了解罕见的乳腺组织细胞 -肌母细胞样癌的病理形态学特征和鉴别诊断要点。方法 应用常规病理及免疫组化技术 ,结合文献进行形态学观察和分析。结果 癌组织呈组织细胞 -肌母细胞样 ,癌旁散在分布反应性肉芽肿 ;瘤细胞体积大 ,胞质宽 ,富有泡沫状及嗜酸性颗粒 ,核仁明显。免疫组化染色GCDFP-15、CK7和EMA ,E cadherin,CD6 8、AB PAS部分细胞和CgA(+) ,actin、S 10 0、vimentin、ER、PR和Syn(- )。结论 乳腺组织细胞 -肌母细胞样癌十分少见 ,同时伴反应性肉芽肿及神经内分泌分化者更为罕见 ,GCDFP 15阳性支持其是大汗腺癌的一种特殊亚型。需与纤维组织细胞病变、肌母细胞瘤 (颗粒细胞瘤 )

Objective To investigate the histopathological features and differential diagnosis of histiocytoid-myoblastomatoid breast carcinoma. Methods The pathological features were studied in a case of histiocytoid-myoblastomatoid breast carcinoma by using general pathological and immunohistochemical methods. Results The carcinoma cells presented histiocytoid-myoblastomatoid differentiation, with the responsive granuloma. The tumor cells were mainly large, uniform, round-to-oval with abundant foamy-to-granular eosinophilic cytoplasm. Immunohistochemically, the tumor cells was positive for GCDFP-15,CD68,CK7,EMA, E-cadherin, AB/PAS and CgA and negative for actin, S-100, vimentin, ER, PR, and Syn. Conclusions Histiocytoid-myoblastomatoid breast carcinoma is a rare variant of breast carcinoma with the responsive granuloma and neuroendocrine differentiation, which is regarded as a specific group of apocrine carcinomas with GCDFP-15 positivity. It should be differentiated from fibrohistiocytic tumor, or myoblastomatoid (granular cell) tumor.