乳腺黏液囊肿样病变的组织病理分析

Histopathology of the breast mucocele-like lesion

目的分析乳腺黏液囊肿样病变(mucocele-like lesion,MLL)的组织病理学特点,并进行相关文献复习。方法对8例乳腺黏液囊肿样病变进行临床病理分析。组织化学AB和PAS染色,SP法进行AE1/AE3、P63、c-erbB-2免疫组织化学染色。结果8例MLL患者均为女性,平均年龄39岁,7例临床可触及肿块,均位于单侧乳房,平均大小2.6 cm。病变大体上呈多囊性,切面呈黏稠胶冻样。组织学上均可见大小不一、扩张的多囊性改变,囊内充满黏液。囊肿内衬扁平或立方上皮,囊肿外层可见肌上皮细胞。被覆上皮可有乳头状增生(2例)及不典型增生(1例)。较多囊肿内黏液穿破囊肿壁进入间质形成无内衬上皮的黏液湖。囊肿内或间质黏液湖中可见数量不一的细钙化,部分病例囊肿周围有不同程度的慢性炎症细胞浸润。囊内及间质内黏液湖特染AB及PAS染色均呈阳性。囊肿内衬上皮及黏液湖中腺管上皮AE1/AE3阳性,其外侧可见数量不一的P63阳性的肌上皮细胞。c-erbB-2染色均阴性。结论乳腺黏液囊肿样病变是一种独立的良性乳腺增生性瘤样病变,需与黏液腺癌等进行鉴别,有必要对患者进行定期随访。

Objective To analysis the histopathologic characteristics of the breast mucocele-like lesions（MLL） and to review the related literatures. Methods We analyzed the clinical and pathological features of 8 cases of breast MLL,and organize chemical AB and PAS staining as well as SP method for AE1/AE3,P63 and c-erbB-2 immunohistochemical staining. Results Eight cases of MLL patients were females with average age of 39 years.Seven cases presented with palpable masses and located in the unilateral breast.Grossly,lesions were polycystic,sticky jelly-like aspect.Histologically,MLL could be seen expansion of multi-cystic changes filled with mucus.Cysts lined with flat or cuboidal epithelium.The lining epithelium had papillary hyperplasia（2 cases） or atypical hyperplasia（1 case）.Extravasated mucinous lakes were seen in the stroma without cellular component. Conclusions Breast mucocele-like lesion was a benign proliferative lesion and differentiated from mucinous adenocarcinoma.It was necessary to conduct regular follow-up patients with MLL.