Yamaguchi Hirohiko, Sakakibara Takashi, Hino Mako, Ryu Misa, Senuma Kouji, Nakai Katsuya, Tomiki Yuichi, Sakamoto Kazuhiro, Kamano Toshiki, Tsurumaru Masahiko, Matsumoto Toshiharu
First Department of Surgery, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Breast Cancer. 2002;9(2):175-8. doi: 10.1007/BF02967584.
A 36-year-old woman presented with a 10 mm diameter mass in the right breast. Since the mass persisted for 3 months after detection and mammary carcinoma was suspected based on ultrasonographic findings, the mass was resected. Histologically, the mass demonstrated proliferative margins and consisted of spindle cells with bland cytologic features and abundant collagen. Immunohistochemically, the spindle cells were positive for vimentin and smooth muscle actin, and were negative for cytokeratins and desmin. Furthermore, the cells showed MIB-1 immunoreactivity with a MIB-1 labeling index of 4.1. Based on these findings, was diagnosed fibromatosis. Breast fibromatosis is rare and is usually misdiagnosed as breast carcinoma preoperatively. To date, only 10 cases of breast fibromatosis have been reported in Japan. Among the reported cases in Japan, our patient presented with the smallest mass, and ultrasonographic findings in this case were the same as those of other cases. Our experience and a review of the literature indicated that differentiation of fibromatosis from carcinoma is very difficult by ultrasonographic examination. In our case, despite involvement of the surgical margins, there was no recurrence. This may be attributed to the small size of the mass and focal exposure.
一名36岁女性因右乳出现直径10毫米的肿块前来就诊。由于该肿块在被发现后持续存在3个月，且根据超声检查结果怀疑为乳腺癌，遂对肿块进行了切除。组织学检查显示，肿块边缘呈增生性，由具有温和细胞学特征和丰富胶原纤维的梭形细胞组成。免疫组织化学检查显示，梭形细胞波形蛋白和平滑肌肌动蛋白呈阳性，细胞角蛋白和结蛋白呈阴性。此外，细胞显示MIB-1免疫反应性，MIB-1标记指数为4.1。基于这些发现，诊断为纤维瘤病。乳腺纤维瘤病较为罕见，术前通常被误诊为乳腺癌。迄今为止，日本仅报道过10例乳腺纤维瘤病病例。在日本报道的病例中，我们的患者肿块最小，且本病例的超声检查结果与其他病例相同。我们的经验及文献回顾表明，通过超声检查很难将纤维瘤病与癌区分开来。在我们的病例中，尽管手术切缘受累，但未出现复发。这可能归因于肿块较小及局部暴露。
