Gupta Deepali, Croitoru Claudia M, Ayala Alberto G, Sahin Aysegul A, Middleton Lavinia P
Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center, Houston, TX, USA.
Ann Diagn Pathol. 2002 Jun;6(3):141-7. doi: 10.1053/adpa.2002.33880.
Histiocytoid carcinoma is a rare type of invasive breast carcinoma. It has been considered to be a variant of lobular carcinoma, a variant of apocrine ductal carcinoma, and an apocrine variant of lobular carcinoma and to resemble lipid-rich carcinoma. In attempts to elucidate its histogenesis, investigators have used mucin and oil red O histochemical analysis and GCDFP-15 immunostaining. E-cadherin is a relatively recent addition to the armamentarium of immunohistochemical markers used for cell differentiation and is a member of a family of transmembrane glycoproteins that has been shown to have a strong correlation with the histologic phenotypes of breast carcinoma. Most ductal carcinomas show diffuse membrane expression of E-cadherin, and lobular carcinomas are characterized by complete lack of membrane staining of E-cadherin. The object of this study was to use E-cadherin immunohistochemical analysis to help clarify the histogenesis of histiocytoid carcinoma. Fourteen cases containing the diagnosis of histiocytoid carcinoma of the breast were identified at M. D. Anderson Cancer Center (Houston, TX) from 1988 to 2001. All cases were rereviewed, histologic features were evaluated, and immunohistochemical staining with E-cadherin and GCDFP-15 was performed. Clinical information was extracted from the patients' medical records. Eleven cases met published histologic criteria for histiocytoid carcinoma. The remaining three cases were apocrine carcinoma. The pattern of tumor infiltration was solid, without secondary lumen formation in all cases of histiocytoid carcinoma. Lobular carcinoma in situ was identified in eight cases, but was absent in three. There was no E-cadherin immunohistochemical staining in eight of the 11 cases of histiocytoid carcinoma (72.7%). GCDFP-15 was immunoreactive in all 10 cases of histiocytoid carcinoma where it was performed. Follow-up data was available for nine of the 11 cases of histiocytoid carcinoma: six patients were alive with disease at 1.5 to 48 months, one patient had died of disease at 60 months, and two patients had no evidence of disease at 32 and 45 months. We conclude that histiocytoid carcinoma has an immunophenotypical profile consistent with both ductal and lobular differentiation. Moreover, the lack of consistent morphologic features, a specific clinical profile, and a distinct immunohistochemical pattern lead us to hypothesize that histiocytoid carcinoma is not a special type of breast cancer.
组织细胞样癌是一种罕见的浸润性乳腺癌。它曾被认为是小叶癌的一种变异型、大汗腺导管癌的一种变异型、小叶癌的大汗腺变异型，且类似于富含脂质癌。为了阐明其组织发生，研究人员采用了黏液和油红O组织化学分析以及GCDFP - 15免疫染色。E - 钙黏蛋白是用于细胞分化的免疫组化标志物库中相对较新的成员，是跨膜糖蛋白家族的一员，已被证明与乳腺癌的组织学表型有很强的相关性。大多数导管癌显示E - 钙黏蛋白的弥漫性膜表达，而小叶癌的特征是E - 钙黏蛋白完全缺乏膜染色。本研究的目的是利用E - 钙黏蛋白免疫组化分析来帮助阐明组织细胞样癌的组织发生。1988年至2001年在德克萨斯大学MD安德森癌症中心（休斯顿，德克萨斯州）确定了14例诊断为乳腺组织细胞样癌的病例。对所有病例进行了重新评估，评估了组织学特征，并进行了E - 钙黏蛋白和GCDFP - 15免疫组化染色。从患者的病历中提取了临床信息。11例符合已发表的组织细胞样癌组织学标准。其余3例为大汗腺癌。在所有组织细胞样癌病例中，肿瘤浸润模式均为实性，无继发腔隙形成。8例发现小叶原位癌，但3例未发现。11例组织细胞样癌中有8例（72.7%）无E - 钙黏蛋白免疫组化染色。在进行检测的所有10例组织细胞样癌中，GCDFP - 15呈免疫反应性。11例组织细胞样癌中有9例有随访数据：6例患者在1.5至48个月时仍有疾病存活，1例患者在60个月时死于疾病，2例患者在32和45个月时无疾病证据。我们得出结论，组织细胞样癌具有与导管和小叶分化一致的免疫表型特征。此外，缺乏一致的形态学特征、特定的临床特征和独特的免疫组化模式使我们推测组织细胞样癌不是一种特殊类型的乳腺癌。
