Shirley Suzanne E, Escoffery Carlos T, Titus Ian P, Williams Elaine E, West A Brian
Department of Pathology, University of the West Indies, Mona, Jamaica.
Ann Diagn Pathol. 2002 Aug;6(4):250-6. doi: 10.1053/adpa.2002.35399.
Primary clear cell carcinoma of the breast is a rare tumor. The clear cell morphology of the neoplastic population in these tumors has been ascribed to the presence of intracellular lipid, mucin or glycogen, or to myoepithelial, apocrine, or neuroendocrine differentiation. However, a clear cell neoplasm exhibiting evidence of a range of differentiation has not been previously reported. We describe a case of a glycogen-rich primary clear cell breast carcinoma occurring in a 59-year-old woman that showed positivity for apocrine and neuroendocrine markers, as well as possible myoepithelial differentiation. The tumor was a 4-cm mass composed predominantly of periodic acid-Schiff-positive clear cells arranged in a solid, infiltrative pattern. Immunohistochemical staining of the tumor cells was variably positive for cytokeratin, progesterone receptors, gross cystic disease fluid protein-15, neuron specific enolase, chromogranin, and S-100 protein and negative for estrogen receptors, smooth muscle actin, CD31, and CD34. The patient refused any form of further investigation or treatment, but shows no evidence of recurrence or metastatic disease after 18 months of follow-up.
原发性乳腺透明细胞癌是一种罕见肿瘤。这些肿瘤中肿瘤细胞群的透明细胞形态归因于细胞内脂质、黏液或糖原的存在，或肌上皮、大汗腺或神经内分泌分化。然而，此前尚未报道过表现出一系列分化证据的透明细胞瘤。我们描述了一例发生在一名59岁女性身上的富含糖原的原发性乳腺透明细胞癌病例，该病例显示大汗腺和神经内分泌标志物呈阳性，以及可能存在肌上皮分化。肿瘤为一个4厘米大小的肿块，主要由呈实性、浸润性排列的过碘酸希夫染色阳性的透明细胞组成。肿瘤细胞的免疫组化染色对角蛋白、孕激素受体、巨大囊肿病液体蛋白-15、神经元特异性烯醇化酶、嗜铬粒蛋白和S-100蛋白呈不同程度阳性，对雌激素受体、平滑肌肌动蛋白、CD31和CD34呈阴性。患者拒绝任何形式的进一步检查或治疗，但在18个月的随访后未显示复发或转移性疾病的证据。
