伴反应性肉芽肿的乳腺癌

Breast carcinoma with responsive granuloma

目的 :研究伴反应性肉芽肿的乳腺癌的临床病理特点。方法 :观察 5例伴反应性肉芽肿的乳腺癌的形态学改变。结果 :5例病人都没有全身性肉芽肿性疾病。癌组织内均可见非干酪性肉芽肿 ,肉芽肿沿癌细胞分布 ,其内有朗汉斯多核巨细胞。区域性淋巴结内没有反应性肉芽肿。结论 :伴反应性肉芽肿的乳腺癌需要和乳腺伴破骨细胞样巨细胞的癌、伴破骨细胞样巨细胞的化生性癌、肉芽肿性小叶性乳腺炎、间质反应性巨细胞、伴结节病或伴结核病的癌鉴别。

Purpose To study the clinicopathological features of breast carcinoma with responsive granuloma. Methods Five cases of breast carcinomas with responsive granuloma were investigated by morphological observation. Results All the five patients had noncaseating epithelioid granulomas. Multinucleated giant cells, predominantly of Langhans type, were present in granulomas. The granulomas were restricted to the carcinoma, and no responsive granulomas were evident in the regional lymph nodes. None of the patients had clinical evidence of systemic granulomatous disease. Conclusion Differential diagnosis of breast carcinoma with responsive granuloma should include the carcinoma with osteoclast like giant cells, metaplastic the carcinoma with osteoclastic giant cells, granulomatous lobular mastitis, stromal responsive giant cells, and carcinoma with sarcoidosis or tuberculosis of the breast.