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乳腺黏液性囊腺癌与浸润性导管癌并存。

Mucinous cystadenocarcinoma of the breast coexisting with infiltrating ductal carcinoma.

作者信息

Chen Wei-Yu, Chen Ching-Shyang, Chen Hsin-Chi, Hung Yi-Ju, Chu Jan-Show

机构信息

Department of Pathology, Taipei Municipal Wan-Fang Hospital, Taipei, Taiwan.

出版信息

Pathol Int. 2004 Oct;54(10):781-6. doi: 10.1111/j.1440-1827.2004.01755.x.

Abstract

A recently described and rare variant of breast carcinoma, mucinous cystadenocarcinoma (MCA), is reported in a 65-year-old post-menopausal woman. She presented with a gradually enlarged breast tumor. A well-circumscribed tumor measuring about 3 cm in diameter was noted in the mammographic and ultrasonographic examinations. The mammographic and ultrasonographic findings were indistinguishable from more common mucinous carcinoma (colloid carcinoma) of the breast. The gross appearance of the tumor was well-defined and cystic, consisting of abundant transparent to bloody mucin, as well as whitish solid parts. Microscopically, the tumor was characterized by abundant extracellular and intracellular mucin. It looked like a mucinous cystic neoplasm of the ovary and pancreas. Particularly, few microscopic foci of ordinary intermediate-grade infiltrating ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) were observed around the main lesion in this case. A transition from ordinary DCIS to MCA in situ was found. It might indicate MCA derives from a metaplasia process of ordinary DCIS. MCA can be easily differentiated from mucinous carcinoma by quite different histologic and immunohistochemical findings. According to the previously reported and present cases, MCA of the breast more commonly affects elderly women and has a relatively favorable prognosis.

摘要

本文报道了一名65岁绝经后女性患有一种最近才被描述的罕见乳腺癌变体——黏液性囊腺癌(MCA)。她因乳腺肿瘤逐渐增大前来就诊。在乳腺X线摄影和超声检查中发现了一个边界清晰、直径约3 cm的肿瘤。该肿瘤在乳腺X线摄影和超声检查中的表现与更常见的乳腺黏液癌(胶样癌)难以区分。肿瘤大体外观边界清晰且呈囊性,由大量透明至血性黏液以及白色实性部分组成。显微镜下,肿瘤的特征是细胞外和细胞内有大量黏液。它看起来像卵巢和胰腺的黏液性囊性肿瘤。特别是,在该病例的主要病变周围观察到了少数普通中级浸润性导管癌(IDC)和导管原位癌(DCIS)的微小病灶。发现了从普通DCIS到原位MCA的转变。这可能表明MCA源自普通DCIS的化生过程。通过截然不同的组织学和免疫组化结果,MCA很容易与黏液癌区分开来。根据先前报道的病例以及本病例,乳腺MCA更常见于老年女性,且预后相对较好。

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