Fadare Oluwole, Mariappan M Rajan
Department of Pathology, Wilford Hall Medical Center, Lackland AFB, TX, USA.
J Med Case Rep. 2008 Apr 30;2:138. doi: 10.1186/1752-1947-2-138.
Mucocele-like tumor was originally described in 1986 as a benign breast proliferation consisting of multiple dilated cysts lined by cytologically bland, flat to cuboidal cells. Subsequent reports described the coexistence of, including the morphologic inter-transitions between, mucocele-like tumor and a variety of other breast proliferations, including intraductal carcinoma, invasive carcinoma, atypical ductal hyperplasia, and hyperplasia of the usual type. The spectrum of breast alterations characterized by variably enlarged terminal-ductal lobular units lined by variably hyperplastic and variably atypical columnar cells has been the subject of significant discussion in the recent literature. In one scheme, these lesions may be classified into four groups, that is, columnar cell change with and without atypia and columnar cell hyperplasia with and without atypia. Morphologic and molecular observations suggest an association, perhaps in a nonobligate precursor role, between some columnar cell lesions and a variety of other neoplastic lesions.
We describe the case of a 43-year-old woman whose breast tumor contained areas diagnostic of mucocele-like tumor and columnar cell hyperplasia, with morphologic transitions in between.
Our case represents the second broadly similar case that has been reported, and suggests a potential relationship between these two enigmatic lesions.
黏液囊肿样肿瘤最初于1986年被描述为一种良性乳腺增生,由多个扩张的囊肿组成,内衬细胞学上温和的扁平至立方细胞。随后的报告描述了黏液囊肿样肿瘤与多种其他乳腺增生(包括导管内癌、浸润性癌、非典型导管增生和普通型增生)的共存,包括它们之间的形态学过渡。以终末导管小叶单位不同程度增大、内衬不同程度增生和不同程度非典型性的柱状细胞为特征的一系列乳腺改变,是近期文献中大量讨论的主题。在一种分类方案中,这些病变可分为四组,即有和无非典型性的柱状细胞改变以及有和无非典型性的柱状细胞增生。形态学和分子学观察表明,一些柱状细胞病变与多种其他肿瘤性病变之间可能存在关联,或许是一种非必然的前驱关系。
我们描述了一名43岁女性的病例,其乳腺肿瘤包含诊断为黏液囊肿样肿瘤和柱状细胞增生的区域,且两者之间存在形态学过渡。
我们的病例是已报道的第二例大致相似的病例,并提示这两种神秘病变之间可能存在关联。