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目的观察乳腺分泌性癌的形态学特征、免疫组化特点及组织化学特点,探讨鉴别诊断和临床预后。方法收集2例乳腺分泌性癌的临床资料,观察其组织形态学特征,采用组织化学PAS及黏液卡红观察分泌物的性质,采用免疫组化SP法观察ER、PR、Her2、CK5/6、P53、S100、GCDFP-15、CyclinD1、E-ca、P120、Ki-67在肿瘤细胞中的表达。结果 2名患者均为女性,年龄分别为40岁和53岁,2例组织学形态基本类似,肿瘤主要呈实性巢状微囊状生长,可见少许腺管状生长。肿瘤细胞形态较一致,胞浆丰富淡泡沫状或颗粒状,胞浆内外可见大量均质粉染或红染嗜酸性分泌物,细胞核圆形或卵圆形,罕见核分裂相,可见小核仁。免疫组化CK5/6、CyclinD1呈阳性表达,ER、PR、Her2未见表达,PAS染色阳性。结论乳腺分泌性癌是一种罕见的实体性肿瘤,呈低度恶性肿瘤的生物学行为,确诊需依据病理形态学、组织化学和免疫组织化学。
Objective To observe the morphological, immunohistochemical and histochemical features of secretory carcinoma of the breast, and to explore the differential diagnosis and clinical prognosis. Methods The clinical data of 2 cases of secretory carcinoma of the breast were collected. The histopathological features were observed. The secretions were observed by histochemical PAS and mucardin. The expressions of ER, PR, Her2, CK5 / 6, P53, S100, GCDFP-15, CyclinD1, E-ca, P120, Ki-67 in tumor cells. Results Both of the two patients were female, aged 40 years and 53 years old. The histological morphology of the two cases were similar. The neoplasms of the two tumors were mostly neoplastic microencapsulated and slightly glandular tubular. Tumor cells more consistent morphology, rich in pale cytoplasm foam or granular cytoplasm can be seen both inside and outside a large number of homogeneous cytoplasm pink stain or eosinophilic secretions, nucleus round or oval, rare mitotic phase, showing small nucleolus. Immunohistochemical CK5 / 6, CyclinD1 positive expression, ER, PR, Her2 no expression, PAS staining positive. Conclusions Breast secretory carcinoma is a rare solid tumor with biological behavior of low grade malignancy. The diagnosis should be based on pathomorphology, histochemistry and immunohistochemistry.