摘要
目的探讨叶状肿瘤内出现癌的临床病理学意义。方法复习1例乳腺叶状肿瘤内出现小叶瘤变及浸润癌病例的临床病史和影像学资料,行组织学检查、免疫组化标记并复习文献。结果患者女性,51岁。右侧乳腺肿物。穿刺活检:良性叶状肿瘤,间质假血管瘤样增生明显;局部区域见小叶瘤变,病灶约3个小叶区域,有微小浸润癌出现。免疫组化:小叶瘤变、浸润癌部分和叶状肿瘤间质成分均分别表达上皮系列及间叶系列标记。说明叶状肿瘤和其内出现的浸润癌是两种不同来源的肿瘤。结论叶状肿瘤内出现癌少见,如果出现此类情况提示碰撞瘤的存在,如果是恶性叶状肿瘤就有可能存在癌肉瘤。但良性叶状肿瘤中出现灶状浸润癌成分不应归类为癌肉瘤,应视为碰撞瘤。
Objective To explore the invasive carcinomas arising in phyllodes tumor representing an uncommon manifestation of breast cancer. Methods We report the ease of a 51-year-old woman who underwent mammary biopsy for a benign phyllodes tumor measuring 11 era. Results I-Iistologieal workup of the specimen revealed lobular neoplasis and perhaps with mieroinvasive carcinoma about three ]obular areas with a invasive area 1 mm in diameter within the phyllodes tumor. The results of IHC showed that lobular neoplasis, invasive caneinomas and the stromal components of phyllodes tumor were positve for epithelial markers and stromal markers, respectively, suggesting the phyllodes tumor and the invasive eaneinomas in it comes from different origin. The papers reports also shows there are different gene mutation in epithelial and stromal components in same kind eases. Conclusion The coexisting of phyllodes tumor and carcinoma appears to represent a true collision tumor, and the existence of carcinoma within a malignant phyllodes tumor has been proposed to qualify for the designation of true carcinosareoma of the breast.
出处
《诊断病理学杂志》
CSCD
北大核心
2013年第9期560-563,共4页
Chinese Journal of Diagnostic Pathology
关键词
乳腺
叶状肿瘤
小叶瘤变
碰撞瘤
癌肉瘤
Breast
Phyllode tumor
Lobular neoplasis
Cancer
Collode tumor
Carcinosarcoma