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目的探讨乳腺癌人类腋窝淋巴结输卵管内膜异位症(ES)临床病理学特征、鉴别诊断要点,提高对其认识。方法回顾性分析1例乳腺癌患者腋窝淋巴结输卵管ES,分析其病理组织学和免疫表型特征,并复习相关文献。结果患者女性,36岁。右乳腺浸润性癌,非特殊类型;Nottingham分级Ⅰ级。腋窝淋巴结(5/27枚)见良性上皮包涵体35个,主要位于被膜下(57%)和被膜内(40%),最大径86~403μm。镜下见上皮包涵体呈分化良好的腺体,被覆单层柱状上皮,细胞核垂直于基底膜,没有明显结构和细胞异型性。腺体被覆纤毛或顶浆分泌的柱状上皮,柱状上皮间夹杂少量胞质透明的细胞,类似输卵管内膜上皮。免疫组化染色示腺上皮细胞PAX-8和WT-1(+),GATA3(-)。结论腋窝淋巴结ES是一种罕见腺体异位,诊断依据其病理组织学形态及免疫表型,并与患者乳腺癌组织形态对比,可与淋巴结癌组织转移鉴别。
Objective To investigate the clinicopathological features of tubal endometriosis (ES) in human breast cancer with axillary lymph nodes and to differentiate the diagnosis points and improve their understanding. Methods A retrospective analysis of one case of breast cancer patients with axillary lymph node ES, analysis of its histopathological and immunophenotypic characteristics, and review the relevant literature. Results Patients Female, 36 years old. Right breast invasive carcinoma, non-specific type; Nottingham grade Ⅰ. There were 35 benign epithelial inclusions in the axillary lymph nodes (5/27), which were mainly located under the capsule (57%) and within the capsule (40%) with the largest diameter of 86 to 403 μm. Microscope, see epithelial inclusions were well-differentiated gland, monolayer covered epithelial cells, the nucleus perpendicular to the basement membrane, there is no obvious structure and cell atypia. Gland epithelium covered by ciliated or apical secretion of secreted columnar epithelium with a small amount of cytoplasm transparent cells, similar to the tubal endometrial epithelium. Immunohistochemical staining showed that the epithelial cells of PAX-8 and WT-1 (+), GATA3 (-). Conclusion Axillary lymph node ES is a rare glandular ectopic diagnosis based on its histopathological features and immunophenotypes. It is also associated with breast cancer tissue morphology and lymph node metastasis.