Yamaguchi Rin, Horii Rie, Maki Keiko, Maeda Ichiro, Date Yuko, Nakamura Takashi, Miyagi Yumi, Iwase Takuji, Akiyama Futoshi
Department of Pathology, Cancer Institute Hospital, Tokyo, Japan.
Pathol Int. 2009 Mar;59(3):185-7. doi: 10.1111/j.1440-1827.2009.02348.x.
Herein is reported a rare case of carcinoma arising from papilloma of the breast. A 63-year-old postmenopausal woman noticed a nodule approximately 1 cm in diameter in her left breast. Ultrasonography indicated a mass with a solid pattern within an intracystic tumor measuring 1.5 x 1.5 x 1.4 cm in diameter located near the left nipple. On total image analysis malignancy could not be denied, therefore lumpectomy with resection of the surrounding tissue was performed. Histologically the tumor consisted of cancerous and papilloma components. The cancer cells had high-grade nuclear atypia, were irregular, and contained abundant eosinophilic cytoplasm with a thin vascular stalk. In contrast, the tumor cells had no atypia, and had a thick stroma in the papilloma components. Both lesions could be distinguished clearly from each other. In addition, a transition from papillary to cancerous elements in some areas was seen. An additional partial mastectomy was performed after the lumpectomy but no carcinoma foci were noted in the excised tissue. Possible occurrence of cancerous change in solitary intraductal papilloma of the breast was suspected.
本文报道了一例罕见的起源于乳腺乳头状瘤的癌。一名63岁的绝经后女性发现左乳有一个直径约1厘米的结节。超声检查显示在左乳头附近有一个直径1.5×1.5×1.4厘米的囊内肿瘤，其中有一个实性肿块。在整体图像分析中不能排除恶性可能，因此进行了肿块切除术并切除周围组织。组织学上，肿瘤由癌和乳头状瘤成分组成。癌细胞有高级别核异型性，形态不规则，含有丰富的嗜酸性细胞质和细血管蒂。相比之下，乳头状瘤成分中的肿瘤细胞无异型性，有厚的间质。两种病变可清晰区分。此外，在某些区域可见从乳头状成分向癌成分的转变。肿块切除术后又进行了部分乳房切除术，但在切除组织中未发现癌灶。怀疑乳腺孤立性导管内乳头状瘤可能发生癌变。
