乳腺浸润性微乳头状癌临床病理观察

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。

Invasive micropapillary carcinoma of breast: a clinicopathological observation

Objective To study the clinical and pathological features,diagnosis and classification of invasive micropapillary carcinoma of the breast(IMC).Methods The clinical manifestations,histopathological features,immunohistochemisty,treatment and prognosis were analyzed in two cases of IMC with review of the literature.Results No special clinical situations were found in two cases.Microscopically,the tumor was characterized by morula-like clusters and small papillae of malignant cells floating within irregular interstitial spaces and separated by fibrous septa in 2 cases.Immunohistochemical studied showed a strong reactivity of most IMC cells for estrogen receptors,CK7 and EMA.Conclusions IMC is a rare variant of invasive ductal carcinoma.A predominat component of IMC in breast carcinoma is associated with a higher risk of lymphovascular invasion and nodal metastasis.IMC can be diagnosed by combination of histopathology with immunohistochemisty.