Lee W Y, Cheng L, Chang T W
Department of Pathology, National Cheng Kung University Medical Center, Tainan, Taiwan.
Acta Cytol. 1999 Mar-Apr;43(2):273-6. doi: 10.1159/000330992.
Cystic hypersecretory duct carcinoma (CHC) of the breast, first described in 1984, is a rare variant of duct carcinoma. Histologically it is characterized by the formation of dilated ducts and cysts containing an eosinophilic secretory product resembling thyroid colloid. The lining epithelium of the cysts atypically proliferates to form intraductal carcinoma. Only four cases of invasive cystic hypersecretory carcinoma have been reported.
We present a case of invasive CHC with tumor emboli in many lymphatic spaces and axillary nodal metastases. The lesion was also evaluated by fine needle aspiration. Direct smears with Papanicolaou stain were highly cellular and had abundant, intensely staining, orange-to-gray-green thyroid colloid-like material. Epithelial cells, showing a variety of cellular patterns, were indistinguishable from usual ductal carcinoma cells. These cytologic findings may be characteristic enough to suggest cystic hypersecretory carcinoma.
The cytologic features of CHC are distinctive and correlate with histology. This was the first presentation of colloidlike secretory material in cytologic material with Papanicolaou stain in such a case. Invasive CHC tends to have aggressive behavior. Cystic hypersecretory hyperplasia coexisted in this case.
乳腺囊性高分泌性导管癌（CHC）于1984年首次被描述，是导管癌的一种罕见变体。组织学上，其特征是形成扩张的导管和含有类似甲状腺胶体的嗜酸性分泌产物的囊肿。囊肿的衬里上皮细胞非典型增生形成导管内癌。仅报道过4例浸润性囊性高分泌性癌。
我们报告1例浸润性CHC病例，其在多个淋巴间隙有肿瘤栓子且有腋窝淋巴结转移。该病变也通过细针穿刺进行了评估。巴氏染色的直接涂片细胞丰富，有大量强烈染色的橙色至灰绿色甲状腺胶体样物质。显示出多种细胞形态的上皮细胞与常见的导管癌细胞无法区分。这些细胞学发现可能具有足够的特征性以提示囊性高分泌性癌。
CHC的细胞学特征独特且与组织学相关。在这种情况下，这是首次在巴氏染色的细胞学材料中出现胶体样分泌物质。浸润性CHC往往具有侵袭性。该病例中存在囊性高分泌性增生。
