乳腺导管内乳头状癌15例临床病理特点并文献复习

Clinicopathological Features of 15 Cases with Intraductal Papillary Carcinoma of Breast

目的:探讨乳腺导管内乳头状癌的临床病理特点、诊断与鉴别诊断要点。方法:对15例乳腺导管内乳头状癌进行临床病理、组织形态及免疫组织化学分析,结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果:15例乳腺导管内乳头状癌在HE切片形态观察中,表现为乳头状结构,乳头轴心纤细或宽广,乳头被覆单一的腺上皮,肌上皮完全消失或不连续,腺上皮单层柱状或多层,与纤维轴心垂直,瘤细胞有不同程度的异型性。免疫组化SMA、p63显示肌上皮缺如或不连续;高分子量细胞角蛋白CK5/6在乳腺癌组织未见表达或仅有散在灶性弱表达。结论:乳腺导管内乳头状癌是一种罕见的乳腺低度恶性肿瘤,预后较好;免疫标记CK5/6、SMA和 p63可以帮助该肿瘤的诊断;主要应注意与乳腺导管内乳头状瘤鉴别。

Objective： To study clinicopathological features, diagnosis and differential diagnosis of intraductal papillary carcinoma of breast. Methods： The features of clinicopathology, histopathological morphology and immunohistochemistry of 15 cases of breast intreductal papillary carcinoma were analyzed with the review of literature. Results： All 15 cases showed papillary structure under low-power microscopy. The papillary was covered with monolayer or muhilayer glandular epithelium which was perpendicular to the axis of palliary and showed variable heteromorphism. Immunostaining of SMA and p63 showed that myoepithelium was absent or discontinuous. The cancerous epithelium showed no or little expression of CK 5/6. Conclusion： Intraductal papillary carcinoma of breast is a rare and low grade malignante tumor with favorable prognosis. Immunostaining of SMA, p63 and CK 5/6 is helpful for correct diagnosis. The main differential diagnosis is intraductal papillary adenoma.