Composite type of breast carcinoma with endocrine differentiation: A cytological and immunohistochemical study
Composite type of breast carcinoma with endocrine differentiation: A cytological and immunohistochemical study
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具有内分泌分化的复合型乳腺癌：细胞学和免疫组织化学研究
DOI：
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发表时间：
2004
期刊：
影响因子：
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通讯作者：
Y. Shibayama
中科院分区：
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作者：
Y. Kurisu;M. Tsuji;Komei Akashi;M. Kobayashi;K. Sumiyoshi;F. Nohara;M. Tanigawa;H. Akutagawa;Y. Egashira;Y. Shibayama
我们描述了一例乳腺癌伴内分泌分化，包含三种不同组织学特征的混合物，发生在一名71岁的女性。组织学上，肿瘤主要是导管内，但轻微浸润。在导管内病变中，肿瘤主要由卵圆形至圆形细胞组成，具有中等至大量的颗粒状嗜酸性细胞质或胞浆内粘蛋白（产生粘蛋白的原位癌）。 它还部分由饱满的梭形细胞组成，细胞质稀少，含有呈小梁状的嗜银颗粒或血管周围的假血管排列（非典型类癌样特征）。浸润性病变（粘液癌）可见粘液湖和漂浮在粘液中的肿瘤细胞。免疫组化染色显示导管内和浸润性病变的肿瘤细胞的内分泌分化。这些发现表明，不同的组织学特征来自多能细胞的内分泌分化，以及肿瘤细胞的内分泌分化已经发生在癌发生的早期阶段，在粘液癌的外观之前。在细胞学上，浆细胞样肿瘤细胞呈松散的聚集簇或在粘液物质背景下呈稀疏的单个细胞。
We describe a case of breast carcinoma with endocrine differentiation containing a mixture of three different histological features that occurred in a 71‐year‐old woman. Histologically, the tumor was predominantly intraductal, but slightly invasive. In the intraductal lesion, the tumor consisted mainly of ovoid to round cells with a modest to abundant amount of granular eosinophilic cytoplasm or intracytoplasmic mucin (mucin‐producing carcinoma in situ). It also consisted, in part, of plump spindle cells with scant cytoplasm that contained argyrophilic granules in a trabecular pattern or an arrangement of perivascular pseudorosettes (atypical carcinoid tumor like‐features). Mucous lake and tumor cells floating in mucin were seen in the invasive lesion (mucinous carcinoma). Immunohistochemical staining revealed endocrine differentiation of the tumor cells of both intraductal and invasive lesions. These findings suggest that the different histological features derived from pluripotent cells upon endocrine differentiation, and that endocrine differentiation of the tumor cells had already occurred at an earlier stage of carcinogenesis, prior to the appearance of the mucinous carcinoma. Cytologically, plasmacytoid tumor cells appeared in loosely cohesive clusters or as sparsely single cells in a background of a mucinous substance.