Murakami Ayumi, Kawachi Kae, Sasaki Takeshi, Ishikawa Takashi, Nagashima Yoji, Nozawa Akinori
Department of Pathology, Yokohama City University Medical Center, Yokohama, Japan.
Pathol Int. 2009 Mar;59(3):188-92. doi: 10.1111/j.1440-1827.2009.02349.x.
Sebaceous carcinoma (SC) of the breast is a rare malignant tumor and only nine cases, including the present one, have been reported in the English-language literature. The present report describes a case of mammary SC in a 50-year-old Japanese woman. The tumor was gray-white on cut surface and separate from the skin and the nipple. Microscopically, lobules encircled by a fibrous envelope and cords or small cell nests in the stroma were noted. These two types of structures were composed of dark cells and clear foamy cells. The dark cells had large nuclei and amphophilic cytoplasm. The clear foamy cells had numerous lipid vacuoles, confirmed on immunostaining with anti-adipophilin antibody and electron microscopy. In the lobules the gradual transitions from basal dark cells to central clear foamy cells and comedo-like necrosis were observed. The tumor cells were positive on immunohistochemistry for cytokeratins (CAM5.2, AE1/AE3), Her2/neu and androgen receptor but negative for estrogen and progesterone receptors. This is the first case of an androgen receptor-positive mammary SC to be reported, and therefore contributes to the understanding of the clinicopathological features of SC of the breast.
乳腺皮脂腺癌（SC）是一种罕见的恶性肿瘤，英文文献中仅报道过9例，包括本文所述病例。本报告描述了一名50岁日本女性的乳腺SC病例。肿瘤切面呈灰白色，与皮肤和乳头分离。显微镜下可见由纤维包膜环绕的小叶以及间质中的条索或小细胞巢。这两种结构均由深色细胞和透明泡沫细胞组成。深色细胞有大核和嗜双色性细胞质。透明泡沫细胞有大量脂质空泡，抗脂肪分化相关蛋白抗体免疫染色及电子显微镜检查证实了这一点。在小叶中观察到从基底深色细胞到中央透明泡沫细胞的逐渐转变以及粉刺样坏死。肿瘤细胞免疫组化显示细胞角蛋白（CAM5.2、AE1/AE3）、Her2/neu和雄激素受体呈阳性，但雌激素和孕激素受体呈阴性。这是首次报道雄激素受体阳性的乳腺SC病例，因此有助于了解乳腺SC的临床病理特征。
