Kurokawa Kei, Mouri Yukako, Asano Atsushi, Kamei Keitaro, Iwata Yosuke, Isogai Masatoshi, Saga Shinsuke, Ichihara Shu
Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
Pathol Int. 2009 Feb;59(2):91-7. doi: 10.1111/j.1440-1827.2008.02334.x.
Herein is described a unique case of breast carcinoma with two different types of giant cells noted in both cytological and histological specimens. A 51-year-old Japanese woman noticed a hard mass in the upper outer quadrant of her left breast. Aspiration cytology exhibited numerous anaplastic giant cells; the cytological diagnosis was high-grade ductal carcinoma, although a few osteoclastic giant cells were also observed. A left simple mastectomy and sentinel lymph node biopsy were performed. Histologically, approximately 90% of the tumor was composed of giant cells; conventional invasive ductal carcinoma and ductal carcinoma in situ were found focally at the periphery of the tumor. The main part of the tumor contained both anaplastic, neoplastic giant cells and non-neoplastic, osteoclastic giant cells that were distinguishable from nuclear atypism. The presence of the two types of giant cells was also confirmed on immunohistochemistry using a histiocytic marker (CD68) and two epithelial markers (AE1/AE3 and CAM5.2). Based on the latest World Health Organization classification, the diagnosis was pleomorphic carcinoma with osteoclastic giant cells. To the authors' knowledge there has been no previous report on this subject except for a single case mentioned in Rosen's Breast Pathology.
本文描述了一例独特的乳腺癌病例，在细胞学和组织学标本中均发现了两种不同类型的巨细胞。一名51岁的日本女性注意到左乳外上象限有一个硬块。穿刺细胞学检查发现大量间变性巨细胞；细胞学诊断为高级别导管癌，尽管也观察到一些破骨细胞样巨细胞。进行了左侧单纯乳房切除术和前哨淋巴结活检。组织学上，约90%的肿瘤由巨细胞组成；在肿瘤周边局部发现了传统浸润性导管癌和原位导管癌。肿瘤主要部分包含间变性肿瘤性巨细胞和非肿瘤性破骨细胞样巨细胞，可通过核异型性加以区分。使用组织细胞标记物（CD68）和两种上皮标记物（AE1/AE3和CAM5.2）进行免疫组织化学检查也证实了两种类型巨细胞的存在。根据世界卫生组织最新分类，诊断为伴有破骨细胞样巨细胞的多形性癌。据作者所知，除了罗森《乳腺病理学》中提到的一个病例外，此前尚无关于该主题的报道。
