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目的探讨乳腺骨肉瘤伴浸润性导管癌的临床病理特征、诊断和鉴别诊断,提高对该肿瘤的诊断水平。方法对1例乳腺骨肉瘤伴浸润性导管癌进行光镜、免疫组化观察,并结合文献讨论。结果大体:左乳腺外上象限可触及3cm×2cm的包块,质较硬,活动度欠佳,与边界不清。镜下:肿瘤性骨质排列紊乱,骨及骨样基质周边被覆于肿瘤细胞,部分区域瘤细胞呈浸润性导管癌样排列。结论乳腺骨肉瘤是一种少见的肿瘤,本例伴浸润性导管癌更为罕见。诊断主要依靠病理形态学及免疫组化,并应与乳腺癌肉瘤、伴有骨或软骨化的乳腺癌及伴破骨细胞样巨细胞乳腺癌等疾病相鉴别。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of breast osteosarcoma with invasive ductal carcinoma and improve the diagnostic level of this tumor. Methods One case of breast osteosarcoma with invasive ductal carcinoma was observed by light microscopy and immunohistochemistry. The literature was discussed. As a result, the outer quadrant of the left breast can reach a mass of 3cm x 2cm, which is harder, less well-actuated, and has unclear boundaries. Microscopically, the tumor was disorganized and the bone and bone-like stroma were covered with tumor cells. In some areas, the tumor cells were arranged in an infiltrating ductal carcinoma. Conclusion Mammary osteosarcoma is a rare tumor. This case is more rare with invasive ductal carcinoma. The diagnosis depends mainly on pathological morphology and immunohistochemistry, and should be differentiated from breast cancer sarcoma, breast cancer with bone or cartilage, and osteoclast-like giant cell breast cancer.