伴印戒细胞成分乳腺癌的临床病理学观察

目的　探讨伴印戒细胞成分乳腺癌的病理特征及诊断 ,鉴别诊断要点。方法　经HE、AB/PAS及免疫组化对 8例伴印戒细胞成分乳腺癌进行观察 ,并文献复习。结果　本组患者均为女性 ,平均年龄 5 4 6岁 ,肿块平均 2 6cm ;组织学以浸润性乳腺癌伴多少不等的典型印戒样癌细胞为特征 ,6 / 8例为浸润性小叶癌 ,其中 5 / 6例ER、PR阳性表达 ;2 / 8例浸润性导管癌 ,1/ 2例ER、PR阳性 ;7/8例癌细胞中印戒细胞成分超过 10 %;4例做AB/PAS均提示印戒细胞浆内的粘液表达 ;印戒细胞成分的多少与病人预后有关系。结论　伴印戒细胞成分乳腺癌是乳腺癌中的一种特殊类型 ,排除转移及与粘液腺癌的鉴别诊断尤为重要。

Clinical and Pathological Study of Primary Breast Carcinoma with Signet-ring Cell Variant

Objective To investigate the pathologic features and differential diagnosis of primary breast carcinoma with signet-ring cell variant.Methods 8 cases of primary breast carcinoma with signet-ring cell variant were studied by analysis of HE and immunohistochemistry and literature review.Results The patients in our data were all female and the average age was 54.6 years.Tumor size ranged from 1.2 to 4.0 cm(mean,2.6 cm).Histologically,in 7/8 cases,signet-ring cells accounted for more than 10% of the neoplastic cell.The tumor was characterized by signet-ring cells in infiltrating breast carcinoma.6/8 cases showed histologically infiltrating lobular carcinoma and 2/8 cases showed histologically infiltrating ductal carcinoma.AB/PAS staining in 4 cases showed intracytoplasmic mucin.The immunohistochemical staining showed that ER and PR were positive in 5/6 patients with infiltrating lobular carcinoma and 1/2 patients with infiltrating ductal carcinoma.There was some relationship between percentage of signet-ring cells and prognosis.Conclusion Primary breast carcinoma with signet-ring cells is a specific variant of breast carcinoma.Differential diagnosis with mucinous cancer and absence of primary signet-ring cell carcinoma elsewhere is important.