男性乳腺导管扩张症临床病理观察

Mammary duct ectasia in males:a clinicopathological analysis

目的探讨男性乳腺导管扩张症(MDE)的临床病理特征、免疫表型、诊断与鉴别诊断。方法结合文献对1例男性MDE的临床资料进行回顾性分析。结果患者男性,47岁。患左乳肥大3年,近期发现乳头下包块。B超示左乳低回声团块,内部回声不均。巨检见病变质硬,其内散在的导管轻度扩张,中心区囊性变。镜下可见乳腺发育,导管增生,管周大量淋巴细胞浸润、灶性多核巨细胞反应及弥漫性浆细胞浸润。免疫组化显示LCA和CD38(+)。结论男性乳腺导管扩张症非常罕见,需要与乳腺癌等其他相似病变鉴别。

Objective To study the clinicopathologic features, diagnosis and differential diagnosis of mammary duct ectasia （MDE） in males. Methods One case of MDE in male was analysed histopathologieally and immunohistochemically, followed by review of related literature. Results The patient was a 47-year-old male, who presented with a three-year of history gynecomastia. Recently, a small mass was found near the nipple of his left breast. Ultrasonogram revealed the mass with an internal heterogeneous hypoeehoic. Grossly, the mass was described as a firm lesion with scattered ducts that dilated slightly and cystic change in center area. Morphologically, gyneeomastia with some tubular proliferations were seen. Meanwhile, numerous lymphocytes, loci multinuelear giant cells were observed in periducts accompanied with diffusely infiltrated plasma ceils showing CD38 or/and LCA positive. Conclusions MDE is extremely rare in males. Recognization of the clinical and pathologic features of this lesion is helpful in differential diagnosis of it from some mimics such as breast cancer.