超声鉴别诊断乳腺典型髓样癌与不典型髓样癌的价值分析

目的分析病理证实的乳腺髓样癌及不典型髓样癌的超声及病理资料,证明超声诊断乳腺髓样癌价值。方法回顾性分析114例乳腺髓样癌病灶病理资料,将其分为髓样癌组及不典型髓样癌组,分析其超声声像图中病灶的形态、大小、边缘、边界、内部回声、血流情况等,探讨两组超声声像图的差异。结果乳腺典型髓样癌病灶93例,不典型髓样癌病灶21例,两组的超声声像图上各特征均无明显统计学差异。超声诊断典型髓样癌和不典型髓样癌良恶性的准确性分别为83.87%、85.71%。结论超声对鉴别乳腺髓样癌良恶性方面具有诊断价值,但在鉴别髓样癌与不典型髓样癌方面价值有限。     

乳腺典型髓样癌与不典型髓样癌临床病理分析

目的探讨乳腺典型与不典型髓样癌的临床病理特征和生物学行为差异。方法对乳腺典型髓样癌及不典型髓样癌各20例临床病理资料进行分析,并采用S-P法检测nm23、E-cad、p53、ER、PR、c—erbB—2、CD45RO和CD20的表达。结果典型髓样癌组,癌细胞合体性结构〉75％,无腺管结构,间质见弥漫性淋巴细胞浸润;不典型髓样癌组,可见腺管结构,间质无或少量淋巴细胞浸润。免疫组化检测典型髓样癌nm23、E—cad阳性表达均高于不典型髓样癌。典型组随访12～84月（平均37个月）,均无腋下淋巴结转移,均健在;不典型组随访9～84月（平均29．5个月）,腋下淋巴结转移4／20例,其中4例分别于术后1—3年内死亡。结论①要严格掌握乳腺典型髓样癌与不典型髓样癌的病理诊断标准。②不典型髓样癌不完全等同“乳腺浸润性导管癌伴髓样特点。”③乳腺典型与不典型髓样癌的预后不同,前者明显优于后者。     

甲状腺髓样癌的超声特征分析及诊断价值

目的:探讨甲状腺髓样癌(medullary thyroid carcinoma,MTC)的超声影像特征及诊断价值.方法:回顾性分析2016年1月至2019年12月经昆明医科大学第三附属医院病理确诊的33例MTC患者共49个结节和100例甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者...     

乳腺肉瘤样癌

观察乳腺肉瘤样癌的病理形态学特点,分型,并分析其与某些肿瘤的鉴别诊断。方法１５３８例乳腺恶性肿瘤中１５例（０．９８％）诊断为乳腺肉瘤样癌,行ＡＥ１／ＡＥ３、上皮膜抗原（ＥＭＡ）、波形蛋白、Ｓ－１００蛋白、肌动蛋白、雌激素受体（ＥＲ）和孕激素受体（ＰＲ）ＳＰ法免疫组织化学染色。另有６例是外院会诊病例,共２１例。结果按其肉瘤样成分的特点分为４个形态学类型：（１）多形肉瘤型：肉瘤样成分为多形肉瘤样。（２     

乳腺浸润性导管癌与小叶癌的超声诊断分析

目的探讨乳腺浸润性导管癌和浸润性小叶癌的超声声像图特征。方法对2006年1月至2008年6月经手术、病理证实为乳腺浸润性导管癌（IDC）136例和浸润性小叶癌61例的超声声像图、彩色多普勒表现进行对比分析。结果两种病理类型的肿瘤的超声声像图在肿块形状、内部与后方回声以及血流图上差异有统计学意义（P〈0．05）。在侧方回声与内部钙化情况上差异无统计学意义（P〉0．05）。结论乳腺浸润性导管癌和浸润性小叶癌可以根据各自超声声像的特点进行诊断，组织学的不同影响乳腺癌的超声影像表现。     

乳腺浸润性导管癌的高频彩色多普勒超声诊断分析

分析了52例乳腺浸润性导管癌患者的彩色多普勒超声图像。对肿块的大小、形态、边缘、回声、钙化、毛刺征、腋下淋巴结肿大、血流分级、阻力指数进行统计,并用用SPSS12.0统计软件进行处理,P<0.05为有显著性差异。彩色多普勒超声声像图对乳腺浸润性导管癌具有临床诊断价值。     

遗传性甲状腺髓样癌的诊断及治疗

目的探讨遗传性甲状腺髓样癌的诊断及诊疗，为其早期诊断及正确治疗提供依据。方法总结遗传性性甲状腺髓样癌患者的临床资料，对其病因、早期诊断及治疗等方面进行探讨。结果遗传性性甲状腺髓样癌是一种由RET原癌基因的种系突变引起的常染色体显性综合征。发病通常是多病灶性和双侧性的，并且大部分（95％）都发生在年轻人；合理的手术治疗可以取得满意的疗效。结论遗传性性甲状腺髓样癌是一种遗传性疾病，早期诊断、合理的手术治疗治疗可以取得满意的疗效。患者家族成员应长期随访。     

乳腺浸润性组织细胞样癌1例

患者女 ,6 5岁 ,因发现左乳无痛性包块 6个月伴同侧腋下淋巴结肿大入院。查体 :左乳房外上象限距乳头 5ｃｍ处可触及一包块 ,活动差 ,有深压痛。包块处乳腺皮肤呈桔皮样外观 ,约 6ｃｍ× 5ｃｍ ,累及乳头边缘。同侧腋下可触及多枚肿大淋巴结。实验室检查 :未发现异常。消化道钡餐透示未发现异常。临床诊断 :左乳癌。遂行左乳癌根治术。病理检查　乳癌根治术切除标本及腋下和锁骨上下部分软组织。乳腺外上象限脂肪组织中有一约 3 5ｃｍ× 2 5ｃｍ× 2ｃｍ灰白色结节 ,质硬 ,与周围软组织粘连 ,切面灰白色 ,部分区域细腻 ,并见有肿大的淋巴结…     

降钙素在甲状腺髓样癌诊治中的意义及甲状腺髓样癌临床特点分析

探讨降钙素 (CT)在甲状腺髓样癌 (MCT)诊断和治疗中的意义 ,并回顾分析MCT的临床特点。以手术和病理证实的 31例MTC为对象 ,起病年龄 (4 2 8± 6 7) (2 1～ 6 7)岁 ,以年龄和性别相匹配的骨质疏松症患者为对照。血清CT和甲状旁腺素采用放射免疫法检测。血钙、磷、碱性磷酸酶采用自动生化分析仪测定。 31例患者中男性 19例 ,女性 12例 ;散发型 2 2例 (71% ) ,合并多发性内分泌腺瘤病 (MEN) 9例 (2 9% ) ;多于中青年起病。首发症状主要是逐渐长大的颈前肿物 ,临床症状为不同程度的消耗症状、腹泻、腹痛、多汗、声音改变等。合并MEN的尚有高儿茶酚胺的表现。甲状腺均触及肿大 ,质硬、活动度差 ,7例有颈淋巴结肿大。患者人均手术 (1 4± 0 7) (1～ 4 )次 ,病理以甲状腺滤泡旁细胞增生为特点 ,降钙素免疫组织化学染色均阳性 (6例 ,10 0 % )。肿瘤易于复发 (4 1 9% )和转移(5 4 8% )。术前和复发时CT水平为 (14 6 5 2 3± 1314 0 1)ng/L ,明显高于正常和骨质疏松对照组 (P <0 0 0 1) ,术后为(388 99± 374 95 )ng/L ,明显低于术前水平 (P <0 0 1) ,CT与血钙、磷无明显相关性。对于逐渐增大、质硬、伴颈淋巴结肿大的甲状腺肿物 ,应谨惕MCT的可能。血清CT是敏感而特异的MCT标志物 ,对于MCT的早期诊断、     

彩色多普勒超声在诊断乳腺增生症的临床应用分析

目的：对乳腺增生症诊断中彩色多普勒超声的临床应用进行探讨。方法共选取150例乳腺增生症患者,通过彩色多普勒超声的二维声像特征进行分析,针对血流特点进行分析与分型。结果二维声像特征院共有68例单纯乳腺小叶增生型(45%);有57例实性肿块型(38%);25例典型囊性增生型(17%);2例乳管扩张型(1.3%);15例混合病变型(10%);血流特点院实性肿块型9例、混合病变型5例、小叶增生型3例可检测到异常的血流信号。结论在乳腺增生症的诊断中,彩色多普勒超声检查具有很好的临床应用价值。     

The ultrastructure of medullary, atypical medullary and non-medullary carcinomas of the breast

Three medullary, eight atypical medullary and four non-medullary carcinomas of the breast were studied by transmission electron microscopy. Detailed comparison of a number of structural, cytoplasmic and nuclear features failed to confirm previous suggestions that medullary carcinoma cells have a distinctive ultrastructure. Electron microscopy is thus unlikely to be useful in the differential diagnosis of the tumours, nor does it suggest a basis for the good prognosis of medullary carcinoma.     

The cytokeratin profile of medullary carcinoma of the breast

AIMS: The cytokeratin (CK) phenotype and vimentin expression of 31 medullary carcinomas was studied using commercially available antibodies on archived material. Comparing the phenotype of typical and atypical tumours and the phenotype of metastases, the biological significance of cytokeratin and vimentin expression in medullary carcinomas of the breast was determined. METHODS AND RESULTS: Antibodies to CK4, CK5 and 6, CK7, CK14, CK8 and 18, CK19, CK20 and to vimentin were used. All the typical and atypical medullary carcinomas and the metastases (10 cases) stained negatively for CK4 and positively for CK8-18 (CAM5.2). Almost all the tumours were CK7 and CK19 positive and CK20 negative. Twelve per cent of the tumours contained CK14. Twenty-five per cent of the typical, 43% of the atypical and 20% of the metastatic medullary carcinomas showed CK5-6 positivity. No association between the cytokeratin-vimentin profile of the tumours and axillary node metastases, tumour size or oestrogen receptor status was found but instability of CK expression was demonstrated by comparing the primary tumours with their metastases. CONCLUSIONS: : Medullary carcinomas of the breast express all the glandular type CKs including CK19 and additionally a proportion of the tumours expresses some of the CKs typical for myoepithelial cells. There was no correlation with prognostic factors.     

Metastatic medullary thyroid carcinoma to the breast in a patient with combined medullary and papillary carcinoma of thyroid—A case report

We report the fine‐needle aspiration cytology of a case of medullary thyroid carcinoma (MTC) metastatic to the breast in a 66‐year old female within two years of diagnosis of the thyroid tumor. The aspirate of the breast metastases revealed a plasmacytoid population of cells in loose clusters and singly with mild to moderate pleomorphism. Nuclear groves and occasional intranuclear cytoplasmic inclusions were seen. The cells stained positive for calcitonin and negative for thyroglobulin. Use of immunocytochemical methods proved useful to diagnose metastasis which was essential in planning treatment. Cases of metastatic MTC to the breast diagnosed on fine‐needle aspirates reported in the literature are reviewed. Diagn. Cytopathol. 2015;43:343–348. © 2014 Wiley Periodicals, Inc.     

Adenoid cystic carcinoma of the breast diagnosed by fine-needle aspiration

Fine-needle aspiration cytology remains a useful tool for preoperative diagnosis of breast lesions. We describe a case of adenoid cystic carcinoma (ACC) of the breast detected by ultrasound-guided fine-needle aspiration (FNA). Subsequent histopathology corroborated the diagnosis. ACC is a rare but distinctive neoplasm of the breast that can be accurately diagnosed by FNA. Its infrequent presentation, favorable prognosis, and relatively conservative management in the breast prompt us to reinforce its features.     

Medullary carcinoma of the breast: Role of contrast-enhanced MRI in the diagnosis of multiple breast lesions

Medullary carcinoma is a rare breast carcinoma with a syncytial growth pattern and high-grade cytology. It can be difficult to diagnose and may be missed on conventional imaging as the findings may overlap with benign lesions i.e. fibroadenomas. The authors report a case of a 25-year-old female who presented with multifocal breast lumps diagnosed with medullary carcinoma and fibroadenomas. Imaging and pathological correlation with contrast-enhanced MRI are presented in the diagnosis of these lesions.     

Lobular breast carcinoma metastasis to skeletal muscle,two case reports diagnosed by ultrasound guided FNA with evaluation of the roles of interventional cytopathology

Skeletal muscle metastasis from breast carcinoma is a relatively rare clinical entity. We report two cases of breast cancer metastatic to the skeletal muscle, diagnosed by ultrasound guided fine needle aspiration (US‐FNA) biopsy done by interventional cytopathologists at an outpatient cytopathology center. Our two patients presented with lower anterior neck firmness and chest wall mass, respectively. Ultrasound evaluation of our first case demonstrated hypo‐echoic thickened anterior strap muscles while in the second case there was significant distortion of the anatomy from previous surgeries. It was necessary to proceed with FNA biopsy even when their ultrasound findings were equivocal, to establish a definite rapid diagnosis. The immediate onsite evaluation findings were suggestive of malignancy in both cases with subsequent core biopsy confirming the diagnosis of metastatic breast carcinoma. In cytopathology, point‐of‐care (POC) ultrasound is used as an adjunct tool that offers visual guidance during FNA of nonpalpable masses and enables sampling of lesional “hot” spots to ensure specimen adequacy. Studies have demonstrated a reduction in FNA nondiagnostic rates with the use of ultrasound‐guidance consequently reducing health care costs associated with nondiagnostic FNAs. US‐FNA also provides adequate samples for cell block preparations. Metastatic lobular carcinoma of the breast has a wide range of clinical presentations and a high level of suspicion is advised. Cytopathologists‐performed US‐FNA is a proven, less‐invasive, cost‐effective tool that provides timely cytologic diagnosis.     

Medullary breast carcinoma in an 18‐year‐old female: Report on one case diagnosed on fine‐needle cytology sample

Medullary breast carcinoma (MBC) is a rare epithelial malignancy of the breast accounting for about 1–7% of all breast carcinomas. It is characterized by well‐defined borders, a syncytial/solid pattern of growth of high grade atypical cells showing no glandular differentiation and a massive diffuse lympho‐plasmacytic peritumoral infiltrate. Despite the high‐grade atypias characterizing this neoplasm, MBC has been reported to have a better prognosis when compared with the common infiltrating duct carcinoma. MBCs typically lack estrogen and progesterone receptor (ER and PgR) expression and have a low incidence of ERBB2 overexpression. Genetically, they are often associated with BRCA‐1 oncogene mutations and TP53 alterations. While MBC generally occurs in middle‐aged women, ranging from 45 to 52 years of age, we report the case of a 18‐year‐old female patient which was diagnosed by means of fine‐needle cytology sample. Diagn. Cytopathol. 2014;42:445–448. © 2013 Wiley Periodicals, Inc.