乳腺恶性肌上皮瘤1例报道及诊治分析

Breast Malignant Myoepithelial Tumor:a case report

探讨原发于乳腺的恶性肌上皮瘤的临床病理学特点及鉴别诊断和相关文献复习,将1例乳腺恶性肌上皮瘤进行光镜观察及免疫组化染色。结果显示镜下示肿物以梭形细胞为主,肿瘤细胞有异形性,未见到腺样结构,可见核分裂象较多。免疫酶标(LSAB法)示瘤细胞ER(-),PR(-),P63(+),CK(+),CK(H)(+),Vimentin(+),SMA(局部+),C-erB-2(-),Ki67(+)<20%,CD117(-),P53(+)。因此肿瘤为来源于乳腺末端基底膜与腺泡上皮间的肌上皮细胞的恶性肿瘤。复习相关文献,该肿瘤生长迅速,常可复发,预后差。如ER、PR阳性者,可采用内分泌治疗。

To discuss the clinical and pathological characteristic of the primary breast malignant myoepithelioma and differential diagnosis and related literature review. One case of breast malignant myoepithelioma was observed with light microscopy and immunohistochemical staining. Under the microscope showed tumor is given priority to with spindle cell, tumor cell atypia, no adenoid structure, more visible mitoses enzyme immunoassay （methods of LSAB ） showed the tumor cell ER（-）,PR（-）,P63（＋）,CK（＋）,CK（H）（＋）,Vimentin（＋）,SMA（local ＋）, C-erB-2（-）,Ki67（＋）〈20%,CD117（-）,P53（＋）. The tumor is from the real basement membrane and myoepithelial cells between the end of glandular epithelial breast malignant tumor. A review of the literature, the tumor grow up fast, often can relapse, poor prognosis. If ER, PR is positive, can adopt the endocrine therapy.