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目的探讨乳腺浸润性微乳头状癌(IMC)的临床病理特征、诊断及鉴别诊断。方法结合文献对该病的临床表现、组织形态学特点、免疫组化及治疗和预后进行探讨。结果2例乳腺IMC无特殊临床症状及体征。光镜下组织学特征为:缺乏纤维血管轴心的微乳头或管泡状细胞簇在纤细的网状或胶原纤维性间质分隔形成的透明间隙中浸润,不伴有促纤维增生。免疫组化示癌细胞簇外周细胞膜和中间腔缘呈特征性线样EMA(+),雌激素受体及CK7(+)。结论IMC是一种少见而独特的乳腺癌类型,具有高度的淋巴管侵犯及淋巴结转移,组织形态及免疫组化相结合可以正确诊断该病。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of breast invasive micro-papillary carcinoma (IMC). Methods Combined with the literature on the clinical manifestations of the disease, histological features, immunohistochemistry and treatment and prognosis were explored. Results 2 cases of breast IMC no special clinical symptoms and signs. Light microscopic histological features: lack of fiber axis of the micro-papillary or tubular cell clusters in the slender mesh or collagen fibrous interstitial space formed by the infiltration of clear, without the promotion of fiber proliferation. Immunohistochemistry showed that the characteristic cytoplasmic linear EMA (+), estrogen receptor and CK7 (+) were found in the peripheral cell membrane and middle luminal border of cancer cell clusters. Conclusion IMC is a rare and unique type of breast cancer with a high degree of lymphatic invasion and lymph node metastasis. The combination of histomorphology and immunohistochemistry can diagnose the disease correctly.