Kuijper A, Mommers E C, van der Wall E, van Diest P J
Departments of Pathology, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
Am J Clin Pathol. 2001 May;115(5):736-42. doi: 10.1309/F523-FMJV-W886-3J38.
The aim of this study was to make a thorough inventory of the histologic features of epithelium and stroma within and adjacent to breast fibroadenomas in 396 cases. Breast fibroadenomas seemed to display a wide spectrum of proliferative and nonproliferative histologic changes. Hyperplasia (excluding mild hyperplasia) within the fibroadenoma was found in 32.3% of cases. Carcinoma in situ (CIS; 5 ductal, 3 lobular) was found in 8 fibroadenomas (2.0%) removed from 6 patients, the youngest of whom was 40 years of age. In 3 cases CIS was not confined to the fibroadenoma, but also involved the adjacent parenchyma. No invasive carcinoma was present within this series. Complex histologic features were seen in 40.4% of cases, mostly in relatively older patients (mean age, 35.4 years). Hyperplasia in adjacent tissue was found in 8.8% of cases, usually in older patients (mean age, 45.5 years). Known risk-elevating lesions in and around breast fibroadenomas occur frequently and mostly in patients older than 35 years. These findings may have consequences for the clinical management of a subgroup of patients with fibroadenoma.
本研究的目的是全面梳理396例乳腺纤维腺瘤内部及周边上皮和间质的组织学特征。乳腺纤维腺瘤似乎呈现出广泛的增殖性和非增殖性组织学变化。32.3%的病例中发现纤维腺瘤内有增生（不包括轻度增生）。从6例患者切除的8个纤维腺瘤（2.0%）中发现原位癌（CIS；5例导管原位癌，3例小叶原位癌），其中最年轻的患者为40岁。3例原位癌不仅局限于纤维腺瘤，还累及相邻实质。本系列中未发现浸润性癌。40.4%的病例可见复杂的组织学特征，多见于相对年长的患者（平均年龄35.4岁）。8.8%的病例在相邻组织中发现增生，通常见于年长患者（平均年龄45.5岁）。乳腺纤维腺瘤内部及周围已知的风险升高病变经常出现，且大多见于35岁以上的患者。这些发现可能会对一部分纤维腺瘤患者的临床管理产生影响。
