乳腺原发性粒细胞肉瘤1例报告并文献复习

Primary granulocytic sarcoma of breast:A case report with literature review

目的:探讨乳腺原发性粒细胞肉瘤的临床病理特点。方法:回顾性分析1例乳腺原发性粒细胞肉瘤患者的临床资料、组织形态、骨髓形态和免疫表型结果,并复习相关文献。结果:患者女性,34岁,临床表现为右侧乳腺肿块。镜下瘤细胞呈列兵样排列或弥漫分布,瘤细胞形态大小一致,中等大小,圆形或卵圆形,细胞质少,胞核圆形或卵圆形,核分裂象易见,核仁易见,可见不成熟嗜酸性粒细胞散在分布。免疫组化示瘤细胞MPO、CD34、CD45为阳性,CD20、CD3、CD15、CD79α、Syn、CK、EMA、E-cad均阴性。结论:乳腺原发性粒细胞肉瘤临床较罕见,临床表现不具特征性,易误诊为非霍奇金淋巴瘤、浸润性小叶癌等,掌握组织形态和免疫组化特点有助于诊断和鉴别诊断。

Objective：To discuss the clinical and pathological characteristics of primary granulocytic sarcoma of breast.Methods：Retrospectively analyzed the clinical data,histomorphology,bone marrow morphology and immune phenotype of one patient diagnosed as primary granulocytic sarcoma of breast,and the related literatures were reviewed.Results：A 34-year-old female patient had a main physical sign of a local mass in right breast.Histologically,the medium-sized round or oval cells were monotonous and arranged in single-file or diffuse pattern.The cytoplasm was scanty and immature eosinophils were scattered.The nuclei were round or oval with obvious mitoses and distinct nucleoli.Immunohistochemically,the tumor cells were positive for MPO,CD34,CD45,but not CD20,CD3,CD15,CD79α,Syn,CK,EMA and E-cad.Conclusion：Primary granulocytic sarcoma of breast is rare in clinical practice and lacks with specific clinical features and may be misdiagnosed as non-Hodgkin＇s lymphoma,invasive lobular carcinoma,etc.Recognition of its morphological and immunohistochemical characteristics is contributed to the diagnosis and differential diagnosis of granulocytic sarcoma.