Diaz N M, McDivitt R W, Wick M R
Lauren V. Ackerman Laboratory of Surgical Pathology, Department of Pathology, Barnes Hospital.
Arch Pathol Lab Med. 1991 Jun;115(6):578-82.
Microglandular adenosis (MA) of the breast is a benign, disorganized proliferation of glands lined by a single layer of cells. As such, differential diagnosis between MA and tubular carcinoma may be challenging in selected cases. A panel of antibodies was applied to 10 cases of MA and 10 of tubular carcinoma to investigate the potential benefit of immunohistochemistry in the separation of these lesions and the possible role of myoepithelial cells in MA. The luminal cells in nine cases of MA were surrounded by a cuff of muscle-specific actin-reactive cells, which also coexpressed cytokeratin and vimentin. The immunophenotype of these cells is characteristic of myoepithelial differentiation, which was heretofore thought to be lacking in MA. This finding demonstrates that myoepithelial cells are indeed present in MA subjacent to luminal epithelial cells; moreover, it distinghuishes MA from tubular carcinoma, all examples of which were actin negative in this analysis. In addition, circumferential type IV collagen deposition was observed around constituent glands of MA in nine cases but was lacking in all tubular carcinomas. Other markers included in this evaluation (S100 protein, gross cystic disease fluid protein 15, carcinoembryonic antigen, estrogen receptor protein) were of no differential diagnostic value.
乳腺微腺性腺病（MA）是一种由单层细胞衬覆的腺体呈良性、结构紊乱的增生。因此，在某些病例中，MA与小管癌的鉴别诊断可能具有挑战性。应用一组抗体对10例MA和10例小管癌进行检测，以研究免疫组织化学在区分这些病变中的潜在作用以及肌上皮细胞在MA中的可能作用。9例MA的管腔细胞被一圈肌肉特异性肌动蛋白反应性细胞所环绕，这些细胞还共表达细胞角蛋白和波形蛋白。这些细胞的免疫表型具有肌上皮分化的特征，而此前认为MA中不存在这种情况。这一发现表明，在管腔上皮细胞下方的MA中确实存在肌上皮细胞；此外，这也将MA与小管癌区分开来，在本分析中所有小管癌的肌动蛋白均为阴性。此外，9例MA的组成腺体周围观察到IV型胶原呈环状沉积，而所有小管癌均未观察到。该评估中包括的其他标志物（S100蛋白、乳腺囊肿病液体蛋白15、癌胚抗原、雌激素受体蛋白）无鉴别诊断价值。
