乳腺分泌基质的化生性癌的临床病理分析及文献复习

Clinicopathologic analysis and literature review of matrix-producing metaplastic carcinoma of breast

1例乳腺分泌基质的化生性癌(matrix-producing metaplastic carcinoma,MPMC)的患者,女,48岁,自觉左乳肿块4个月余,镜下见浸润癌直接转化为黏液软骨样基质,中间没有梭形细胞过渡区域。免疫表型:肿瘤细胞PCK,CK(34βE12),CK5/6,CK14,S-100,vimentin,EGFR,GATA-3,E-cadherin均阳性,calponin灶状阳性,ER,PR,HER2,P63均阴性,Ki-67增殖指数约50%。特殊染色AB-PAS示:软骨黏液样基质。乳腺化生性癌(metaplastic breast carcinoma,MBC)是一种少见的乳腺浸润性癌,MPMC是一种极其罕见的MBC亚型,具有独特的病理特征,依据临床和病理组织学特点,结合免疫组织化学染色可以明确诊断。

A 48-year old female patient with matrix-producing metaplastic carcinoma of the breast(MPMC) felt a solid mass in the left side of the breast for more than four months unconsciously.Microscopically,the tumor demonstrated ductal carcinoma component with direct transition to areas with cartilaginous differentiation without an intervening spindle cell element.The immunohistochemistry of tumor cells showed positive of PCK,CK(34βE12),CK5/6,CK14,S-100,vimentin,EGFR,GATA-3,E-cadherin,and calponin(focal positive),while negative for ER,PR,HER2.The Ki-67 index was about 50%.Special histochemical staining for AB-PAS highlighted the abundant cartilaginous matrix.MPMC is an extremely rare variant of metaplastic breast carcinoma,with distinctive histopathology features,the diagnosis can be made based on clinical and histopathological features combined with immunohistochemical results.