乳腺小管癌的临床病理分析

目的 探讨乳腺小管癌的临床病理特征、诊断与鉴别诊断要点。方法 通过光镜和免疫组化方法对4例乳腺小管癌进行临床病理分析,结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果 4例乳腺小管癌仅3例有可触及的肿物,另1例仅在B超下发现两个低回声肿块。镜下4例均由高分化的小管结构组成,存在开放的管腔,被覆单层上皮细胞,腺管形状不规则成角状,内含嗜碱性分泌物,可见顶浆分泌的小突起,未见肌上皮细胞及完整的基底膜成分,SMA（-）。间质增生并富于细胞。3例伴有导管内癌,其中1例伴有平坦上皮不典型增生。结论 小管癌的正确诊断需组织形态和免疫组化相结合,并与硬化性腺病、微小腺体腺病、复杂硬化性腺病/放射状瘢痕、以腺管结构为主的乳腺浸润性导管癌等病变相鉴别。

Tubular carcinoma of breast:a clinicopathologic study of 4 cases

Objective To study the clinicopathologic characteristics,diagnosis and differential diagnosis of tubular carcinoma of breast.Methods Four cases of tubular carcinoma of breast were studied by histopathological observation and immunohistochemical staining and the literatures briefly reviewed.Results Three out of the 4 cases had a palpable mass,and the remaining one was detected by ultrasound. All were composed of well-differentiated tubular architecture lined by a single layer of epithelial cells and characterized by angulated contours of the glands,open lumina with basophilic secretion,apocrine-type "snouts" in the apical cytoplasm,cellular nature of the stroma,lack of a myoepithelial cell component and basement membrane and all negative for SMA.Three out of 4 cases were associated with ductal carcinoma in situ and one with flat epithelial atypia.Conclusion Tubular carcinoma of breast could be diagnosed by combination of histopathology with immunohistochemical staining and should be differentiated from sclerosing adenosis,microglandular adenosis,complex sclerosing lesions/radial scars and invasive carcinoma dominant with tubular component.