乳腺癌肉瘤1例报道及文献复习

Carcinosarcoma of the breast: a case report and review of the literature

目的探讨乳腺癌肉瘤的临床病理学特征及其鉴别诊断。方法对1例乳腺癌肉瘤进行组织病理学和免疫表型观察并复习文献,了解该肿瘤的特征。结果镜检显示病变边界清楚,以软骨肉瘤为主,其边缘有少量分化较差的浸润性导管癌成分。免疫表型:软骨肉瘤细胞vimentin强阳性,S100蛋白阳性,ER、PR、cerbB2和CK(AE1/AE3)均阴性;癌细胞CK(AE1/AE3)、ER、PR及cerbB2均阳性,vimentin、S100蛋白阴性。结论原发于乳腺的癌肉瘤较罕见,诊断需与乳腺恶性分叶状肿瘤以及软组织肉瘤鉴别。

Purpose To investigate the clinical and pathological features of breast carcinosarcoma and its differential diagnosis. Methods The histopathology and immunophenotype of a breast carcinosarcoma was studied and the relative literature were reviewed in order to understand the characteristics of the tumor. Results Microscopically, the lesion was relatively well circumscribed. The tumor was predominantly composed of chondrosarcoma with invasive ductal carcinoma at the periphery of the tumor. The chondrosarcoma elements showed vimentin（ ＋ ） , S-100 protein（ ＋ ） , ER（ - ） , PR（ - ） , c-erbB-2（-） , and CK（AE1/AE3） （ - ）. The carcinoma cells showed CK （AE1/AE3） （ ＋ ）, ER（ ＋ ） , PR（ ＋ ）, c-erbB2（ ＋ ）, vimentin（ - ）, and S-100 protein （ - ）. Conclusions Primary carcinosarcoma of the breast is a rare tumor. More attention should be paid in the daily practice in order to differentiate this tumor from malignant phyllodes tumor and primary soft tissue sarcoma of the breast.