乳腺炎性肌纤维母细胞瘤临床病理观察

Coinicopathological observation on the inflammatory myofibroblastic tumor in the breast

目的:探讨乳腺炎性肌纤维母细胞瘤的临床病理学特征、诊断和鉴别诊断等。方法:对2例乳腺炎性肌纤维母细胞瘤进行临床、病理形态以及免疫组化标记,并复习相关文献。结果:2例患者临床表现为乳房肿块伴有胀痛。大体上,肿瘤切面灰白、实性,可有黏液感。镜下,肿块边界清楚或者欠清,黏液或胶原背景下瘤细胞以梭形细胞为主,瘤细胞无明显异型性,核分裂象少见;间质血管丰富,见淋巴细胞、浆细胞等浸润。免疫组化梭形细胞vimentin(+),SMA、Desmin和ALK不同程度(+),而CK、S-100、Myogenin、bcl-2和CD34均(-)。结论:乳腺炎性肌纤维母细胞瘤比较少见,形态多样,并缺乏特异性免疫标记,病理诊断有时较困难,应与一些梭形细胞肿瘤或病变鉴别。

Objective：To investigate the clinicopatholoical features and differential diagnosis of inflammatory myofibroblastic tumor （IMT） in the breast. Methods： Two cases of IMT in the breast were retrospectively examined with regard to the clinical manifestations, histological findings and immunohisto- chemical markers, and related literatures were reviewed. Results： Two female patients generally complained of breast masses with occasional distending pain. Grossly, the specimen presented with solid mass, gray-white on cut sections and myxoid aspect. Microscopy revealed well or relatively poorly-defined tumor border, and that tumor was primarily composed of spindle cells against a myxoid and conagenous background with abundant stromal blood vessels and infiltration of lymphocytes and plasma cells. Cellular atypia and mitosis were rare. The tumor cells were immunoreactive to vimentin, SMA, Desmin, ALK, but negative for CK, S-100,bel-2, Myogenin and CD34. Conclusion： IMT of the breast is extremely rare, and presents with multiple morphology, which makes difficult pathological diagnosis due to insufficient immunohistochemical markers available. Thus, differential diagnosis of this entity shall be distin- guished from other spindle cell carcinoma in the breast or similar lessions, lesion ical features,and has no specific immuno label. So,it is very difficult to make a diagnosis, which need to differentiate with some spindle cell carcinoma or lesions.