乳腺原发腺样囊性癌4例临床病理研究

Clinicopathological Analysis of Four Cases of Breast Adenoid Cystic Carcinoma

目的:探讨乳腺原发性腺样囊性癌的临床病理特征、免疫表型、诊断、鉴别诊断、治疗及预后。方法:收集4例乳腺腺样囊性癌患者的临床资料,结合文献分析其形态学特征、免疫表型、治疗及预后。结果:4例患者均为女性,年龄55~70岁。肿块大体境界尚清楚,切面灰白或灰黄色。镜下肿瘤细胞呈浸润性生长,由腺上皮、肌上皮-基底样细胞构成,排列成特征性的筛状、实体型、梁-管状结构。腺上皮细胞表达CK8/18、CK7、CK5/6、CD117、E-cadherin,肌上皮-基底样细胞表达CK14、SMA、p63、S-100、CD117。4例均行乳腺癌改良根治术,随访7~50个月,均无复发及转移。结论:乳腺腺样囊性癌是一种罕见的低度恶性肿瘤,预后较好,其诊断及鉴别诊断主要依据病理形态学特征和免疫表型。

Objective:To investigate the pathomorphological features,immunophenotype,diagnosis,differential diagnosis,treatment and prognosis of adenoid cystic carcinoma in breast.Methods:The clinicopathological data and immunohistochemical characteristics of breast adenoid cystic carcinoma in 4 cases were analyzed.Results:All 4 cases of breast adenoid cystic carcinoma were females from 55 to 70 years old.The general boundary of the tumor was relatively clear,with cut surface of gray or grayish yellow.Microscopically,the tumor consisted of glandular epithelium cells and myoepithelial-basal-like cells,arranged into characteristic cribriform,solid and trabecular structure.Glandular epithelium cells expressed CK8/18,CK7,CK5/6,CD117 and E-cadherin.Myoepithelium-basal-like cells expressed CK14,SMA,p63,S-100 and CD117.Modified radical mastectomy was performed in all 4 cases,and no recurrence or metastasis was found during the follow-up period of 7 to 50 months.Conclusion:Adenoid cystic carcinoma is a rare subtype of breast carcinoma with favorable prognosis.The diagnosis and differential diagnosis are mainly based on pathomorphological features and immunophenotypes.