乳腺腺肌上皮瘤5例并临床病理分析
摘要
目的探讨乳腺腺肌上皮瘤(adenomyoepithelioma,AME)的临床病理学和免疫表型特征。方法采用HE及免疫组化EnVision两步法对5例AME进行染色,并复习相关文献。结果 5例患者均为女性,年龄45~63岁(平均54岁)。镜下见肿瘤由增生的腺上皮和肌上皮组成,以肌上皮增生为主,多为梭形或透明肌上皮细胞。伴癌的AME中可见肿瘤呈浸润性生长,细胞丰富,异型性明显,核分裂象增多,肿瘤内有坏死。免疫表型:5例肿瘤腺上皮CK强阳性,EMA、ER、PR、SMA、p63、CD10、Calponin、CK5/6均阳性,肌上皮CK弱阳性,ER和PR均阴性。结论 AME为乳腺少见的良性肿瘤,由腺上皮和肌上皮共同增生形成。伴癌的AME更罕见,其恶性成分多为肌上皮,肿瘤转移少,转移者预后差。
引文
[1]廖秋林,赖日权,陈晓东,等.男性乳腺腺肌上皮瘤1例[J].临床与实验病理学杂志,2003,19(4):455.
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[5]Rasbridge S A,Millis R R.Adenomyoepithelioma of the breast with malignant features[J].Virchows Arch,1998,432(2):123-30.
[6]Loose J H,Patchefsky A S,Hollander I J,et al.Adenomyoepithelioma of the breast:a spectrun of biologic behavior[J].Am J Surg Pathol,1992,16(9):868-76.
[7]Trojani M,Guiu M,Trouette H,et al.Adenomyoepithelioma of the breast:an immunohistochemical,cytophotometric,and ultrastructural study of a case with lung metastases[J].Am J Clin Pathol,1992,98(6):598-602.
[8]Rosen P P.Rosen’s breast pathology[M].Philadelphia:Lippincott Williams Wilkins,2008:137-60.
[9]龚西騟,丁华野.乳腺病理学[M].北京:人民卫生出版社,2009:215-6,388-90.
[10]杨文君,陈丽荣,吴翔燕,等.乳腺腺肌上皮瘤临床病理观察及文献复习[J].临床与实验病理学杂志,2007,23(5):545-8.
[11]Chen P C,Chen C K,Nicastri A D,et al.Myoepithelial carcinoma of the breast with distant metastasis and accompanied by adenomyoepithelioma[J].Histopathology,1994,24(6):543-8.
[12]Nadelman C M,Leslie K O,Fishbein M C.“Benign”metastasizing adenomyoepithelioma of the breast:a report of 2 cases[J].Arch Pathol Lab Med,2006,130(9):1349-53.
[13]高仁里,张丹,叶慧英.乳腺恶性腺肌上皮瘤1例临床病理分析及文献复习[J].实用癌症杂志,2011,26(6):642-4.
[14]R K,Murthy V S.Malignant adenomyoepithelioma of breast masquerading as soft tissue lytic lesion of right iliac bone:a rare entity[J].J Clin Diagn Res,2014,8(9):FD03-4.
[15]Petrozza V,Pasciuti G,Pacchiarotti A,et al.Breast adenomyoepithelioma:a case report with malignant proliferation of epithelial and myoepithelial elements[J].World J Surg Oncol,2013,11:285.
[2]Tavassoli F A.Myoepithelial lesions of the breast.Myoepitheliosis,adenomyoepithelioma and myoepithelial carcinoma[J].Am J Surg Pathol,1991,15(6):554-68.
[3]Bult P,Verwiel J M,Wobbes T,et al.Malignant Adenomyoepithelioma of the breast with metastasis in the thyroid gland 12 years after excision of the primary tumor[J].Virchows Arch,2000,436(2):158-66.
[4]Ahmed A A,Heller D S.Malignant adenomyoepithelioma of the breast with malignant proliferation of epithelial elements:a case report and review of the literature[J].Arch Pathol Lab Med,2000,124(4):632-6.
[5]Rasbridge S A,Millis R R.Adenomyoepithelioma of the breast with malignant features[J].Virchows Arch,1998,432(2):123-30.
[6]Loose J H,Patchefsky A S,Hollander I J,et al.Adenomyoepithelioma of the breast:a spectrun of biologic behavior[J].Am J Surg Pathol,1992,16(9):868-76.
[7]Trojani M,Guiu M,Trouette H,et al.Adenomyoepithelioma of the breast:an immunohistochemical,cytophotometric,and ultrastructural study of a case with lung metastases[J].Am J Clin Pathol,1992,98(6):598-602.
[8]Rosen P P.Rosen’s breast pathology[M].Philadelphia:Lippincott Williams Wilkins,2008:137-60.
[9]龚西騟,丁华野.乳腺病理学[M].北京:人民卫生出版社,2009:215-6,388-90.
[10]杨文君,陈丽荣,吴翔燕,等.乳腺腺肌上皮瘤临床病理观察及文献复习[J].临床与实验病理学杂志,2007,23(5):545-8.
[11]Chen P C,Chen C K,Nicastri A D,et al.Myoepithelial carcinoma of the breast with distant metastasis and accompanied by adenomyoepithelioma[J].Histopathology,1994,24(6):543-8.
[12]Nadelman C M,Leslie K O,Fishbein M C.“Benign”metastasizing adenomyoepithelioma of the breast:a report of 2 cases[J].Arch Pathol Lab Med,2006,130(9):1349-53.
[13]高仁里,张丹,叶慧英.乳腺恶性腺肌上皮瘤1例临床病理分析及文献复习[J].实用癌症杂志,2011,26(6):642-4.
[14]R K,Murthy V S.Malignant adenomyoepithelioma of breast masquerading as soft tissue lytic lesion of right iliac bone:a rare entity[J].J Clin Diagn Res,2014,8(9):FD03-4.
[15]Petrozza V,Pasciuti G,Pacchiarotti A,et al.Breast adenomyoepithelioma:a case report with malignant proliferation of epithelial and myoepithelial elements[J].World J Surg Oncol,2013,11:285.