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目的探讨青春期男性乳腺小管癌的临床与病理形态学特点、诊断与鉴别诊断、预后观察及合理的治疗方法。方法应用光镜观察、免疫组化染色方法结合临床资料对1例青春期男性乳腺小管癌进行临床病理分析,并复习相关文献。结果患者青春期男性,发现右乳肿物1年余。细针穿刺考虑为导管内乳头状肿瘤,增生活跃。手术切除标本为灰白色肿物,3 cm×2 cm×1.5 cm大小,质脆,并见直径0.2~0.6 cm的囊腔数个,内可见细乳头状物。镜下肿瘤由开放的单层小管上皮细胞组成,浸润性分布于增生的纤维间质中,细胞异型性不明显,核分裂罕见。在其周伴随微乳头型及筛状型导管内癌结构。免疫组化显示小管外周肿瘤细胞肌上皮标记阴性。术后随访5年,患者一般情况良好。结论发生于青春期的男性乳腺小管癌罕见。需与微腺型腺病、放射状瘢痕、男性乳腺发育等良性病变及具有小管结构的乳腺浸润性导管癌等鉴别。免疫组化有助于鉴别。
Objective To investigate the clinical and pathological features, diagnosis and differential diagnosis, prognosis and reasonable treatment of breast cancer in adolescent boys. Methods A case of adolescent male breast cancer was analyzed by light microscopy and immunohistochemical staining combined with clinical data. Results Patients with adolescent males, found that the right breast tumor more than 1 year. Fine needle aspiration for intraductal papillary tumors, hyperplasia. Surgical resection specimens were gray-white mass, 3 cm × 2 cm × 1.5 cm size, crisp, and see the diameter of 0.2 ~ 0.6 cm several cysts, showing fine nipple. Microscopic tumor by the open monolayer of tubular epithelial cells, invasive distribution in the proliferation of interstitial fibrosis, cell atypia is not obvious, the mitotic rare. In its weeks accompanied by micro-papillary and screened intraductal catheter structure. Immunohistochemistry showed that the tubular epithelial cells of the peripheral tubules were negative. After 5 years of follow-up, the patients were generally in good condition. Conclusions Mild breast cancer occurs in adolescent males. Need with micro-gland adenosis, radial scars, benign breast lesions and other male patients with tubulointerstitial ductal invasive ductal carcinoma and other identification. Immunohistochemistry helps to identify.