目的探讨伴破骨细胞样巨细胞或反应性肉芽肿的乳腺癌的临床病理特点。方法复习11例伴破骨细胞样巨细胞的乳腺癌(carcinoma with osteoclastic giant cells,COGC)和8例伴反应性肉芽肿的乳腺癌(carcinoma with responsive granuloma,CRG)...目的探讨伴破骨细胞样巨细胞或反应性肉芽肿的乳腺癌的临床病理特点。方法复习11例伴破骨细胞样巨细胞的乳腺癌(carcinoma with osteoclastic giant cells,COGC)和8例伴反应性肉芽肿的乳腺癌(carcinoma with responsive granuloma,CRG)的临床病理资料,部分病例行免疫组化染色和特殊染色。结果COGC患者平均年龄40.6岁,CRG患者平均年龄53.6岁,均因发现乳腺包块就诊。COGC多呈界限清楚的结节状,切面多为灰红、灰褐色。COGC肿瘤类型包括浸润性导管癌5例、浸润性乳头状癌、浸润性微乳头状癌和浸润性筛状癌各2例。肿瘤内破骨细胞样巨细胞大小形态各有差异,分布弥散或不均匀,与肿瘤细胞关系密切。肿瘤间质内尚见不同程度的新旧出血、血管和纤维组织增生。腋窝淋巴结癌转移灶保留原发灶的形态学特点。CRG形态多不规则,切面多为灰白色。肿瘤类型均为浸润性导管癌,伴随出现的肉芽肿多密切围绕在癌巢周围,由上皮样细胞和朗汉斯型巨细胞构成。抗酸染色和六胺银染色无阳性发现。进行免疫组化染色病例的破骨细胞样巨细胞和肉芽肿均呈CD68(KP1和PGM1)阳性,S-100蛋白和Ⅷ因子呈阴性。CD34染色显示COGC的微血管密度为(21.9±4.2)/HPF,与对照组浸润性导管癌无明显差异(P>0.05)。获得随访资料的6例COGC和2例CRG在随访期内无复发、转移或死亡。结论乳腺COGC和CRG均属少见肿瘤,前者的大体和组织学具有一定的特异性。破骨细胞样巨细胞和肉芽肿出现的预后意义尚需积累更多的病例进行分析。展开更多
We report the case of a patient with atypical Sweets syndrome characterized by an annular erythema that showed consumption of elastic fibres by giant cells and histiocytes.Although the lesions were found on sunexpos...We report the case of a patient with atypical Sweets syndrome characterized by an annular erythema that showed consumption of elastic fibres by giant cells and histiocytes.Although the lesions were found on sunexposed sites and the first biopsy demonstrated extensive elastophagocytosis, our patient did not have photodamaged skin clinically.A repeat biopsy 5 weeks later demonstrated an abundant collection of neutrophils supporting the diagnosis of Sweets syndrome.To our knowledge, an elastolytic granulomatous reaction pattern has not been previously reported in Sweets syndrome.展开更多
文摘目的探讨伴破骨细胞样巨细胞或反应性肉芽肿的乳腺癌的临床病理特点。方法复习11例伴破骨细胞样巨细胞的乳腺癌(carcinoma with osteoclastic giant cells,COGC)和8例伴反应性肉芽肿的乳腺癌(carcinoma with responsive granuloma,CRG)的临床病理资料,部分病例行免疫组化染色和特殊染色。结果COGC患者平均年龄40.6岁,CRG患者平均年龄53.6岁,均因发现乳腺包块就诊。COGC多呈界限清楚的结节状,切面多为灰红、灰褐色。COGC肿瘤类型包括浸润性导管癌5例、浸润性乳头状癌、浸润性微乳头状癌和浸润性筛状癌各2例。肿瘤内破骨细胞样巨细胞大小形态各有差异,分布弥散或不均匀,与肿瘤细胞关系密切。肿瘤间质内尚见不同程度的新旧出血、血管和纤维组织增生。腋窝淋巴结癌转移灶保留原发灶的形态学特点。CRG形态多不规则,切面多为灰白色。肿瘤类型均为浸润性导管癌,伴随出现的肉芽肿多密切围绕在癌巢周围,由上皮样细胞和朗汉斯型巨细胞构成。抗酸染色和六胺银染色无阳性发现。进行免疫组化染色病例的破骨细胞样巨细胞和肉芽肿均呈CD68(KP1和PGM1)阳性,S-100蛋白和Ⅷ因子呈阴性。CD34染色显示COGC的微血管密度为(21.9±4.2)/HPF,与对照组浸润性导管癌无明显差异(P>0.05)。获得随访资料的6例COGC和2例CRG在随访期内无复发、转移或死亡。结论乳腺COGC和CRG均属少见肿瘤,前者的大体和组织学具有一定的特异性。破骨细胞样巨细胞和肉芽肿出现的预后意义尚需积累更多的病例进行分析。
文摘We report the case of a patient with atypical Sweets syndrome characterized by an annular erythema that showed consumption of elastic fibres by giant cells and histiocytes.Although the lesions were found on sunexposed sites and the first biopsy demonstrated extensive elastophagocytosis, our patient did not have photodamaged skin clinically.A repeat biopsy 5 weeks later demonstrated an abundant collection of neutrophils supporting the diagnosis of Sweets syndrome.To our knowledge, an elastolytic granulomatous reaction pattern has not been previously reported in Sweets syndrome.
