乳腺包裹性乳头状癌35例临床病理特征分析

Encapsulated papillary carcinoma of the breast: a clinical and pathological analysis of 35 cases

目的探讨乳腺包裹性乳头状癌(EPC)的临床病理特征及预后。方法收集35例乳腺包裹性乳头状癌病例,分析其临床资料、组织学特征及免疫组化特点,并复习相关文献。结果35例患者均为女性,平均年龄60.3岁(33~93岁)。肿物最大径0.7~8 cm。其中31例临床表现为乳腺包块,4例为乳头溢液。组织学显示扩张的囊腔局部发生乳头状病变,乳头具有纤维血管轴心,被覆立方或柱状上皮细胞,缺乏肌上皮。免疫组化:肌上皮标记物CK5/6、p63、SMA和calponin均(-)。35例中9例伴浸润性癌,5例伴导管原位癌。19例患者接受乳腺肿物切除术,16例患者行全乳腺切除。随访1~54个月,患者无复发及转移。结论包裹性乳头状癌是一类少见的乳腺恶性肿瘤,预后较好,仔细的形态学观察和准确的免疫组化判读是诊断的关键。

Objective To investigate the clinicopathological features and prognosis of encapsulated papillary carcinoma of the breast. Methods The diagnosis of encapsulated papillary carcinoma of the breast were observed in 35 cases,and relevant patient data were analyzed with review of the literature. Results All 35 cases were female,aged 60. 3 years (range from 33 to 93 years). The tumors were 0. 7 cm to 8 cm in the largest diameter. 31 patients presented with lump of the breast,whereas 4 patients had nipple discharge. Histolopathology showed the dilated cyst with localized papillary lesions. The papilla had fibrous vascular axis,covered with cuboidal or columnar epithelial cells and lacked myoepithelia cells. Immunohistochemistry showed the tumor was negative for CK5/6,P63,SMA and Calponin. Invasive carcinoma was seen in 9 cases,and DCIS in 5 cases. There were 19 lumpectomy specimens and 16 mastectomy specimens. Patients were followed up for 1 month to 54 months without recurrence or metastasis. Conclusions Encapsulated papillary carcinoma is a rare malignant tumor of the breast with excellent prognosis. Meticulous morphological observation and accurate interpretation of immunohistochemistry are imperative for correct diagnosis.