摘要
目的探讨包裹性乳头状癌(EPC)的临床病理特征。方法分析1例以管状和筛状结构为主的男性EPC患者的临床信息,组织形态以及免疫组化染色结果,并文献复习。结果患者为72岁男性。左乳包块。组织学显示肿瘤组织为局限性生长病灶,周围可见纤维性包裹,边缘有微浸润。癌细胞呈不规则管状及筛状结构排列,小管排列较密集,之间可见纤维性间质。癌细胞体积中等偏大,圆形,胞质嗜酸性或局部透亮,核圆形体积中等,轻度异型,染色质淡然,核膜清晰,核仁显著,可见双核仁,核分裂少见。免疫组化显示肿瘤细胞雌激素受体(ER)和孕激素受体(PR)强(+),HER-2(-),肌上皮标记p63、SMA、Calponin均呈(-),p16胞质(+),CD34部分肿瘤细胞膜(+),Ki-67增殖指数约5%。结合文献、形态学、免疫组化结果分析,并且与实性乳头状癌、浸润性筛状癌以及良性管状腺瘤等相鉴别,诊断为男性包裹性乳头状癌。结论EPC为一种较少见乳腺恶性肿瘤,好发于老年女性,形态学特征与多种乳腺良恶性病变容易混淆,需综合分析相鉴别。
Objective To investigate the clinical features of encapsulated papillary carcinoma(EPC).Methods The clinical information,histological morphology and immunohistochemical staining results of a male EPC patient with tubular and ethmoid structures were analyzed,and the literature was reviewed.Results The patient was a 72-year-old male.Lump of left breast was found.Histologically,the tumor was a localized growth lesion with fibrous encapsulation and microinvasion at the edge.The cancer cells were arranged in irregular tubular and cribriform structures,with dense tubules and fibrous stroma between them.Cancer cells were moderately large in size,round in shape,with eosinophilic or locally transparent cytoplasm;moderately round nuclei in size were noted,with slightly heterotypic in shape,with weak chromatin,clear nuclear membrane,prominent nucleoli or rare nucleoli.Immunohistochemistry showed that tumor cells were strongly positive for estrogen receptor(ER)and progesterone receptor(PR),P16 and CD34,but negative for HER-2,myoepithelial markers p63,SMA,and calponin;Ki67 proliferation index was about 5%.Combined with the literature,the results of morphology and immunohistochemistry were analyzed and differentiated from solid papillary carcinoma,invasive ethmoidal carcinoma and benign tubular adenoma,and the diagnosis was male encapsulated papillary carcinoma.Conclusion EPC is a rare breast malignant tumor,which tends to occur in elderly women,and its morphological characteristics are easily confused with various benign and malignant breast lesions,which need to be differentiated by comprehensive analysis.
作者
程波
许琳
丁姗姗
刘珊
孙锁柱
侯庆香
CHENG Bo;XU Lin;DING Shan-shan;LIU Shan;SUN Suo-zhu;HOU Qing-xiang(Department of Pathology,the Medical Center of Rocket Force,Beijing 100080,China;Department of Gynaecology and Pediatrics,the Medical Center of Rocket Force,Beijing 100080,China)
出处
《诊断病理学杂志》
2020年第10期693-696,共4页
Chinese Journal of Diagnostic Pathology
关键词
乳腺
包裹性乳头状癌
男性
免疫组化
Breast
Encapsulated papillary carcinoma
Male
Immunohistochemistry
