原发性乳腺鳞状细胞癌二例

例1女,50岁.发现左侧乳腺肿块5 d于2008年9月15日入院.体检:左乳外上象限可触及-2.0 cm × 1.5 cm肿块,质硬,无压痛,边界不清,活动尚可,乳头无溢液、无内陷,皮肤无橘皮样改变.术中冷冻切片诊断为浸润性乳腺癌,倾向于鳞状细胞癌.行左侧乳腺癌改良根治术及左腋窝淋巴结清扫.     

乳腺原发性印戒细胞癌

目的：观察乳腺原发性印戒细胞癌的形态特征。方法：通过HE及AB/PAS染色,对4例乳腺原发性印戒细胞癌进行观察。结果：4例癌细胞内印戒细胞均超过205。HE染色呈典型印戒样细胞,AB/PAS染色胞质内阳性。导管内型及小叶型各1例,浸润性导管型及小叶型各1例。结论：乳腺原发性印戒细胞癌是一种特殊型癌,诊断时应排除转移性印戒细胞癌。     

乳腺印戒细胞癌一例

患者女，５０岁。发现左侧乳腺肿块８个月，于１９９７年７月２９日就诊。体检：浅表淋巴结无肿大，双侧乳腺外观无异常，在左侧乳房内下象限可扪及６ｃｍ×５ｃｍ×４ｃｍ大小的肿块，稍有压痛，可活动，与皮肤及胸部肌肉无粘连。实验室检查无异常。临床诊断：左侧乳腺肿...     

高原地区子宫颈原发性小细胞癌2例

例1,女性,32岁,白带有血丝伴腰部疼痛1年。患者平素月经规律,量中等,孕产G2 P1,无痛经史。长期生活于海拔3000 m地区。妇科检查：子宫颈轻度肥大,下唇可见3 cm ×2 cm大小外生性肿物,呈球形生长,表面可见异型血管,触血阳性。盆腔轴位CT增强扫描示：子宫颈明显增大,似可见不规则软组织结节影,注药后子宫颈可见3．5 cm×2 cm大小不均匀强化块影,边界清楚。印象：子宫颈癌表现。B超示：子宫颈肥大、子宫颈低回声区。子宫颈HPV分型检测示：HPV 18阳性。液基细胞学检查考虑为小圆细胞肿瘤(图1),建议行阴道镜及活组织检查。临床行子宫颈恶性肿瘤根治术,取大标本送病理检查。例2,女性,40岁,接触性阴道出血2个月余。患者平素月经规律,量中等,孕产G3P2,无痛经史。长期生活在海拔3200 m地区。妇科检查：子宫颈重度肥大,呈桶状,表面糜烂,未见明显肿物,触血阳性。辅助检查：妇科彩超示子宫颈弥漫性肥大,请结合临床诊断。子宫颈HPV分型检测示：HPV 16阳性。遂行全子宫切除术,术后行病理检查。     

宫颈小细胞癌一例

患者女,39岁.因阴道血性分泌物增多及同房后阴道出血6个多月于2007年8月来本院行宫颈液基脱落细胞学(TCT)检查.     

小肠原发性鳞状细胞癌一例

患者男,63岁。以“阵发性腹痛2个月,加重伴肛门停止排便4天”于2003年9月9日入院。体检:右下腹可见肠型和蠕动波,肠鸣音2-3次/分,可闻及气过水声。腹部立卧位X线片示:小肠低位机械性肠梗阻。临床诊断:小肠肿瘤。术中见腹腔内腹水约1500 ml,淡黄色澄清。小肠距屈氏韧带约170 cm处可见一6 cm×5 cm×4 cm大小包块,形状不规则,菜花状,不光滑,质硬,将小肠包裹其中。近侧小肠及结肠空虚,包块附近肠系膜淋巴结肿大。     

鼻腔原发性透明细胞癌一例

患者男,34岁.因反复间歇性右鼻出血1年余,流脓涕2个月于2009年8月入院.鼻腔CT显示右侧筛窦顶部嗅裂区见大小约1.8 cm ×0.8 cm条片状类似软组织密度影,边界清楚,邻近窦腔黏膜未见明显增厚,骨质完整(图1).胸腹CT及腹部B超未见异常.鼻腔检查见鼻腔黏膜光滑无充血,中下鼻甲无肿大,右鼻中道见脓涕,右侧嗅裂见新生物,色红,易出血,基底附着于筛顶部.鼻咽部未见异常.颈部淋巴结无肿大.行鼻内窥镜下右侧鼻腔新生物切除术并送病理检查.     

胃原发性鳞状细胞癌一例

胃原发性鳞状细胞癌一例赵名春，申永璋，付青患者男，４７岁。主因上腹痛７月余、食后上腹饱胀１０天于１９９０年６月１日以“胃癌”收入院。查体：上腹部未扪及明显包块。于１９９０年６月６日行胃癌根治术。手术所见：胃窦部肿块直径约１０ｃｍ，与胰头、横结肠粘连。...     

乳腺继发性小细胞神经内分泌癌1例

患者女性,80岁,因咳嗽、咳痰1个月,加重伴心悸、气短2天。外院检查发现心包积液。于本院心内科治疗病情无明显改善,后发现左侧乳腺外上象限肿物,行乳腺肿物针吸,细胞学检查:见多量成团及乳头状肿瘤细胞,符合癌细胞,遂转入肿瘤科治疗。抽取血性心包积液约300 m l送检,细胞学查见     

小肠原发性鳞状细胞癌一例

患者男,59岁.因反复腹痛20年伴腹胀、呕吐2个月于2008年2月20日入院.无黑便、便血、肛门停止排气排便等症状.体检:腹部丰满,无胃肠型蠕动波,腹部无压痛及反跳痛,未扪及包块,移动性浊音阴性,肠鸣音2-3次/分,无高调肠鸣音及气过水声.辅助检查:腹部平片:小肠不全性肠梗阻,入院后完善相关辅助检查,给予抗感染治疗,对症胃肠减压处理,于2008年2月26日在全麻下行剖腹探查、肠切除、肠吻合术.     

Primary squamous cell carcinoma of the breast: a case report

INTRODUCTION: Primary squamous cell carcinoma (SCC) of the breast is an extremely rare entity and it has a low incidence in comparison with all other mammary cancers. MATERIAL AND METHODS: We describe a case of SCC of the breast in a 55 year old woman who presented with a painless mass located in the external quadrant of the left breast. The neoformation, once removed, was tamponate formalin fixed and routinely processed for inclusion in paraffin. Sections were stained with haematoxilin-eosin and immunohistochemical and electron microscopy investigations were performed. RESULTS: Histologically, the neoplasia was characterized by cystic cavities covered by nests and sheaths of poorly differentiated squamous cells with keratinized areas. Mitotic activity was high, as well as cellular proliferative index, evaluated by Mib-1 (ki 67) antibody. At immunohistochemistry, the tumor cells were diffusely positive for high molecular weight cytokeratins and c-erbB-2, negative for vimentin, estrogen and progesterone. CD68 and LCA were positive only in the inflammatory cells. Electron microscopy confirmed the epithelial nature of the neoplastic cells. A diagnosis of SCC of the breast was made, and a radical mastectomy was performed. CONCLUSIONS: We make a brief review of the literature and discuss the main histologic criteria for the differential diagnosis with adenocarcinoma of the breast with squamous metaplasia.     

Neuroendocrine small cell carcinoma of the breast: report of a case

A rare case of neuroendocrine small cell carcinoma (SmCC) of the breast is reported. A 51-year-old postmenopausal woman noticed a nodule approximately 3 cm in diameter in her right upper breast. Histologically, the tumor consisted of small ovoid to pleomorphic cells with hyperchromatic nuclei, and a large central area was occupied by acellular amorphous tissue. Extensive lymphatic permeation was seen around the tumor. Invasive and in situ ductal carcinoma foci were not observed in and surrounding the tumor. Immunohistochemically, estrogen and progesterone receptors and HER2/neu were all negative in the tumor cells. Synaptophysin and chromogranin A were diffusely positive in the tumor cells. Cytokeratin 8 was only positive in a few tumor cells. The labeling indices of Ki-67 and p53 were high in the tumor. Postoperatively, systemic studies including positron emission tomography were performed but failed to reveal any other possible primary sites, including lung. Based on these findings, the tumor was diagnosed as neuroendocrine primary SmCC of the breast. Postoperatively, the patient received a course of weekly paclitaxel. However, pelvic bone metastasis was identified on a bone scintigram 1 year after surgery. Mammary SmCC showing high Ki-67 and p53 index should be treated carefully because of their aggressive clinical behavior.     

Primary small cell (oat cell) carcinoma of the breast: report of a case and review of the literature

A case of primary small cell (oat cell) carcinoma of the breast in a 41-year-old woman is presented. The patient was alive and well without disease 16 months after modified radical mastectomy and subsequent chemotherapy. The tumor cells revealed morphologic similarity to oat cell carcinoma of the lung and immunohistochemical expression of neuroendocrine markers. In ultrastructural examination, the tumor cells had neurosecretory granules. Review of nine previously reported cases and this case of primary small cell carcinoma of the breast has revealed that this type of tumor shows prominent vascular invasion, frequent lymph node metastasis, infrequent expression of estrogen receptor, and also very poor prognosis. Immunohistochemical study for the c-kit proto-oncogene product, which has been reported to be a specific marker for pulmonary small cell carcinoma, demonstrated positive reactivity in approximately 80% of the tumor cells of this case, which is the first report according to our knowledge. The expression of c-kit might be some aid to the diagnosis of primary small cell carcinoma of the breast.     

Primary gastric small cell carcinoma: report of a case and review of the literature

A 52-year-old man suffering from a pure-type primary gastric small cell carcinoma was treated with surgery and combination chemotherapy. The small cell carcinoma, approximately 6.5 cm in diameter, was situated in the posterior wall of the antrum and there were no distant metasatses. Total gastrectomy and regional lymph node dissection was carried out. Histological examination revealed a solid pattern of proliferation of small cells with hyperchromatic, round nuclei and scant cytoplasm. Neoplastic cells infiltrated into the subserosal layer with severe lymphatic and vascular invasion. Regional lymph node cells were mostly replaced by tumor cells that stained positive for Grimelius, neuron-specific enolase (NSE), and synaptophysin. Accumulations of electron-dense core granules in the small neoplastic cells were seen by electron microscopy. Following surgery, the patient was treated with adjuvant chemotherapy consisting of cisplatin and etoposide. The patient is alive and recurrence free 3 years after surgical operation. We review 107 published cases of primary gastric small cell carcinoma, an extremely rare disease first reported in 1976. Small cell carcinoma is an aggressive, malignant tumor. Intensive chemotherapy is essential for patient survival even when curative surgical resection is carried out.     

Primary neuroendocrine small cell carcinoma of the breast

A 60-year-old Turkish woman presented with a left breast mass, which was considered for neoadjuvant chemotherapy. By the end of the treatment cycles, the tumor had decreased in size, and the patient underwent modified radical mastectomy with axillary lymph node dissection. Pathologic examination of the tumor revealed a small cell carcinoma with neuroendocrine features confirmed by immunohistochemical stains. Multiple axillary lymph nodes were involved by metastatic small cell carcinoma carrying the same morphologic characteristics noted in the primary breast tumor. We hereby present this case as a primary neuroendocrine small cell carcinoma of the breast. This entity occurs very rarely in the breast, and fewer than a dozen cases have been reported in the literature. Extrapulmonary small cell carcinoma of the breast is reportedly a very aggressive tumor for which no consensus for treatment has yet been drawn.