10例乳腺颗粒细胞瘤临床病理分析

Clinicopathological analysis on 10 cases of breast granular cell tumor

目的探讨乳腺颗粒细胞瘤(GCT)的病理特征及临床诊疗情况。方法对山西省人民医院、福建省立医院及南华大学附属第一医院2010年1月至2018年1月收治的10例GCT患者的临床资料进行回顾性分析,并复习相关文献。结果10例GCT患者中,发病年龄39~67岁,中位年龄51岁。X线片均表现为密度增高影。肿瘤均呈浸润性生长,瘤细胞呈实性巢团、簇状或条索状排列,细胞无异型性,无核分裂像。免疫组化S-100蛋白均呈强阳性(10/10),CD68强阳性(10/10),VIMENTIN强阳性(10/10),CK、CK7、SMA均为阴性(-),Ki-67均<3%。10例GCT患者均完整手术切除,随访1~8年,均未见复发。结论GCT为神经来源,可能起源于施万细胞;穿刺及冰冻诊断极易误诊;恶性GCT罕见。

Objective To investigate the clinicopathological characterrisitics, diagnosis, differential diagnosis and prognosis of breast granular cell tumor (GCT). Methods The clinical data of 10 patients with GCT admitted to Shanxi Provincial People’s Hospital, Fujian Provincial Hospital and the First Affiliated Hospital of University of South China from January 2010 to January 2018 were retrospectively analyzed, and the relevant literature was reviewed. Results Among the 10 GCT patients, the age of onset ranged from 39 to 67 years, with a median age of 51 years. The presentation of X-ray showed high density. The tumors were in infiltrative growth pattern, and tumor cells ranged in solid-nest pattern, cluster or streak, without architectural atypia and mitosis. The tumor cells are strongly reactive to S-100 protein (10/10), CD68 protein (10/10), VIMENTIN protein (10/10) according to immunohistochemistry. But they did not show staining for CK, CK7 or SMA, Ki-67<3%. Ten cases all underwent surgical excision. There was no recurrence during 1 to 8-year follow-up. Conclusions GCT arise from nerve, maybe Schwann cells. It’s likely to be misdiagnosed by encounter puncture and frozen. Malignant GCT is rare.