乳腺癌腋窝淋巴结内巨核细胞的形态及意义

Megakaryocytes in axillary lymph node of breast carcinoma

目的认识淋巴结内巨核细胞,并与转移癌鉴别。方法对1例乳腺癌患者腋窝淋巴结内出现的大细胞进行HE形态、免疫组化染色观察并复习文献。结果淋巴结的皮质区及髓质区的窦内及窦旁散在少量大细胞(平均直径50μm,最大者>100μm),这些细胞胞质宽大,嗜酸性,核染色质粗颗粒状或呈分叶状。免疫组化染色:CD61、CD31和F-Ⅷ(+),CD68和AE1/AE3(-)。结论淋巴结内出现巨核细胞非常少见,应根据形态学特点、结合免疫组化结果与转移癌相鉴别。

Objective To identify a benign megakaryocytic lesion in lymph nodes mimicking metastases from breast carcinoma.Methods The lymph nodes of a patient with breast carcinoma were observed with pathologic examination and the related literature was briefly reviewed.Results Isolated large cells were present in the nodal sinuses and/or parasinus in axillary lymph node with a ratio of 8∶20,with multilobulated and hyperchromatic nuclei,and these large cells did not immunoreact with cytokeratin and CD68,but reacted with CD61,CD31 and von Willebrand factor.Conclusion This phenomenon is uncommon and often poorly recognized.In combination with routine HE morphology and immunophenotyping,these cells are confirmed to be nodal megakaryocytes and not metastatic carcinoma.