乳腺胶原小体病与原发乳腺腺样囊性癌的诊断与鉴别诊断

Diagnosis and Differential Diagnosis between Collagenous Spherulosis of Breast and Primary Cribriform Adenoid Cystic Carcinoma of Breast

目的:探讨乳腺胶原小体病与原发乳腺腺样囊性癌的形态和免疫组化特点及诊断、鉴别诊断要点。方法:选取乳腺胶原小体病及乳腺腺样囊性癌各2例,观察其形态学特征,并进行免疫组化及特殊染色。结果:乳腺胶原小体病与乳腺腺样囊性癌的筛网状结构非常相似,在常规HE染色下两者筛孔内的透明球样物有细微差别,对肌上皮标志物(CK5/6、CKH、P63、SMA)及激素受体(ER、PR)表达范围有所不同。结论:乳腺胶原小体病是乳腺的良性增生性病变,与乳腺腺样囊性癌预后及治疗差别很大,需通过组织学与免疫组化综合分析进行鉴别。

Objective： To investigate the morphological and immunohistochemicl features,diagnosis and differential diagnosis of collagenous spherulosis of berast and primary cribriform adenoid cystic carcinoma of breast. Methods： Clinicopathologic observation,immunohistochemistry and histochemical staining were applied in 2 cases of collagenous spherulosis of berast and 2 cases of primary cribriform adenoid cystic carcinoma of breast. Results： Collagenous spherulosis of berast and primary cribriform adenoid cystic carcinoma of breast had similar cribriforms,and the esinophilic spherules in the lumen dyed by hematoxylin and eosin stain had minor differences. Myoepithelial marker（ CK5 /6,CKH,P63,SMA） and homone receptor（ ER,PR） expressional ranges all had differences. Conclusions： Collagenous spherulosis of breast is a benign lesion of breast,and has vary widely prognosis and treatment differences in contrast with primary cribriform adenoid cystic carcinoma of breast. The differential diagnosis need to comprehensive analysis by histology and immunohistochemistry.