乳腺非典型微腺体腺病临床病理观察

Atypical microglandular adenosis of breast: a case report and review of literature

目的 分析乳腺非典型微腺体腺病（MGA）的临床及病理组织学特征.方法 应用光镜观察及免疫组化染色对1例乳腺非典型MGA进行临床病理分析,同时复习相关文献.结果 患者女性,49岁.右侧乳腺浸润性小叶癌切除4年,发现左乳肿物4年.左乳乳腺纤维组织和脂肪组织中可见弥漫增生的腺管及腺泡成分,大部分腺体呈圆形,细胞呈单层立方形,腺腔开放,细胞胞质略透明或嗜酸性,部分腺体腺腔内可见嗜酸性分泌物.局灶间质纤维化,部分区域小腺管结构复杂,细胞增生,腺体融合,细胞出现轻～中度异型性.免疫组化：小腺体S-100强（＋）,CK5/6、p63、SMA、calponin、EMA、ER、PR、c-erbB-2和p53（-）,cathepsin D（＋）,Laminin显示完整基底膜围绕腺体.结论 MGA病例少见,形态学及免疫组化相结合有助于诊断与鉴别诊断.

Objective To analyze the clinical and pathologic features of atypical microglandular adenosis （MGA） of the breast. Methods A case of MGA of the breast was studied by microscopy and immunohistochemistry, with review of related literature. Results The patient was a 49-year-old woman, with a history of resected invasive lobular carcinoma of her right breast 4 years ago, and a mass of her left breast was also found at that time. Histologically, the tumor of her left breast was composed of small round glands and acini infiltrating fibrous septa or fatty mammary stroma. Most of the glands were open and lined by a single layer of cuboidal epithelial cells, with slight clear or eosinophilic cytoplasm and luminal eosinophilic secretions in some glands. Focal fibrosis was present. In some areas, the glandular structures were complex, the proliferative cells showed mild to moderate atypia, with some glands fused. Immunostaining showed that the glands were S-100＋ （strong）, CK5/6-, p63-, SMA-, calponin-, CK＋, EMA-, ER-, PR-,e-erbB-2-, cathepsinD＋, and p53 - , and the intact basement membrane were demonstrated by laminin. Conclusions MGA is a rare lesion. The combination of morphology and immunohistochenmistry is useful for the diagnosis and differential diagnosis.