乳腺大汗腺癌临床和病理学特征研究.doc

乳腺大汗腺癌临床和病理学特征研究 钱福永1 邵牧民 2 △ （1广东医学院附属深圳市第三人民医院Androgen receptor，AR）、雌激素受体(estrogen receptor, ER)C-erbB-2。 结果 4例均发生于中老年女性，因发现乳房包块就诊。3例位于右乳房外上象限，1例位于右乳房内上象限，触及无痛性肿块，4例均于同侧腋窝触及肿大淋巴结。组织学4例均为高级核，其中大汗腺导管原位癌（ADCIS）1例，ADCIS伴浸润性大汗腺癌（IAC）1例，IAC2例。镜下主要有2种形态：A型，胞质嗜伊红染的粗颗粒状；B型，胞质淡染，呈细粉尘颗粒状，如毛玻璃样。4例AC的PAS染色阳性，AB染色在ADCIS阴性，在IAC可有50%细胞阳性，并同时表达GCDPF-15，AR，Mucin-1及Ki-67；除1例外，ER均不表达。 结论 乳腺大汗腺癌的临床表现和大体形态与非乳腺大汗腺癌相似,多发生于单侧并且多数伴有同侧腋窝淋巴结转移，预后较好。其诊断主要依靠病理：①特征性的AC型细胞；②GCDPF-15阳性率高；③AR阳性率高，ER阳性率低。 【关键词】 乳腺肿瘤；大汗腺癌；免疫组织化学；雄激素受体 Clinic and pathological study of apocrine carcinoma of breast . QIAN Fuyong, SHAO Mu-ming . QIAN Fu-yong, SHAO Mu-ming . (1Dept. of Hepatobiliary Surgery,the Affiliated Shenzhen Third People＇s Hospital of Guangdong Medical College ,Guangzhou University of Traditional Chinese Medicine, Shenzhen 518000, China.E-mail:yinsdy2003@163.com 【Abstract】 AIM To investigate the clinicopathological features and the immunohistochemica phenotype of apocrine carcinoma(AC) of breast. METHODS The clinical and pathologic features of 4 cases of AC in breast were investigated. Periodic-acid-Schiff(PAS), alcian-blue staining were performed. The immunohistochemical study was performed by a panel of antibodies including gross cystic disease fluid protein 15(GCDFP-15),Mucin-1,AR,ER,c-erb-2 and Ki-67. RESULTS All four cases occurred in middle to old age female patients, complaining of mass in breast. Masses without pain were found in 3 cases in the outer upper quadrant and 1 case in the inner upper quadrant of right breast, lymph node metastases in ipsilateral armpit were found in 4 cases. Histologically, 4 cases of apocrine carcinomas with high nuclear grade were confirmed, including 1 ADCIS, 1 ADCIS with IAC and 2 IAC. Two types of AC cells were noted according to the morphologic of cytoplasm: A type, neoplastic cells with copious, granular eosinophilic cytoplasm; B type, carcinoma cells with finely granular pale cytoplasm, like frosting glass. AC cells of 4 cases showed positivity for PA