乳腺颗粒细胞瘤7例临床病理分析

Granular cell tumor of the breast: a clinicopathological study of seven cases

目的探讨乳腺颗粒细胞瘤(GCT)的临床表现、病理形态特征及鉴别诊断要点。方法报告7例乳腺颗粒细胞瘤并进行组织形态学、组织化学研究,结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果肿瘤呈浸润性生长,由实性巢团或条索状排列的圆形或多角形细胞组成,胞质粗颗粒状、嗜酸性,细胞边界清楚或不清,核仁明显。D-PAS染色(+)。免疫组化S-100、CD68和PGP9.5(+),CK、CgA、Syn和HMB45(-)。结论乳腺颗粒细胞瘤是一种少见的乳腺肿瘤,通常为良性,手术完整切除预后良好,切除不完整可复发,但也有极少数恶性病例报道,可有淋巴结转移。GCT需与乳腺大汗腺癌、嗜酸细胞癌、神经内分泌癌、恶性黑色素瘤等恶性肿瘤进行鉴别。

Objective To investigate the clinicopathological features and differential diagnosis of granular cell tumor of the breast（ GCT）. Methods Seven cases of GCT were reported. Based on light microscopic observation, an histochemical study was carried out. Their clinical manifestations,pathologic features and main points of differential diagnosis were discussed,and literature was reviewed. Results GCT had an infiltrative growth pattern,and was composed of sheets,clusters or cords of round to polygonal cells that had distinct to inconspicuous cell borders,uniform round to oval nuclei with discernible nucleoli. Mitoses were generally scant. The tumor cells were often positive for periodic acid Schiff（ PAS） diastase-risistant,S-100,CD68 and PGP9. 5,but CK,CgA,syn and HMB45 were negative.Conclusions GCT is a rare lesion of the breast with benign clinical manifestation. Complete resection is good and the tumour may recur if incomplete excised. There are few reported cases of malignancy with lymph node metastasis. GCT should be differentiated from apocrine caicinoma,oncocytic carcinoma,neuroendocrine carcinoma,malignant melanoma and other malignant tumors.