乳腺实体性乳头状癌6例并文献复习

Solid papillary carcinoma of breast in 6 cases and literature review

目的 探讨乳腺实体乳头状癌的临床病理特征并对国内外相关文献进行复习,以提高对乳腺实体乳头状癌的认识和病理诊断水平.方法 归纳6例乳腺实体性乳头状癌患者的临床资料,分析其组织学特征和免疫表型,并结合国内外相关文献进行总结.结果 6例实体乳头状癌发病年龄49～72岁;组织学主要表现为终末导管小叶单位呈膨胀性生长,充填整个导管腔,形成实性片状结构.实性生长区域中有纤细的纤维血管轴心形成,轴心周围细胞呈栅栏状排列或围绕纤维血管轴心形成假菊形团样结构;免疫组织化学显示肿瘤细胞神经内分泌标记出现不同程度阳性表达,ER、PR均呈阳性表达,CK5/6肿瘤细胞阴性,仅呈巢团周围肌上皮和纤维血管轴心肌上皮散在阳性表达,Ki-67呈低表达,c-erbB-2呈阴性表达.结论 乳腺实性乳头状癌是一种比较少见的病理类型,好发于老年女性,具有特征性的组织学和免疫组织化学特点,预后较好.

Objective To explore the clinicopathologic features of solid papillary carcinoma （SPC） of breast and review relative domestic and foreign medical literature,in order to enhance the understanding and the pathological diagnosis level. Methods The clinical dates of 6 patients with SPC of breast were collected,the clinical data and histopathological feature were analyzed with the review of relative medical literature. Results 6 patients were females with age 49 to 72. Histologic mainly for terminal catheter lobular unit expansion growth,filling the whole pipe,forming solid lamellar structure.Solid growth area in a slim fiber axis of blood vessel formation,around the axis of fiber cells were arranged pale or around vascular axis of forming false chrysanthemum group structure.Immunohistochemistry showed positive expression of tumor cell neuroendocrine markers appear different degree,the ER and PR positive expression,CK5/6 tumor cells showed negative,only the nest group myoepithelial and fiber around vascular axis of myoepithelial scattered positive expression,the Ki-67 showed lower expression,c-erbB-2 showed negative expression. Conclusion SPC is a rare pathologic type,occurs in older women,has the characteristic of the histological and immunohistochemical features,the prognosis is good.