Chen Chien-Hung, Rowlands Caroline, Sengupta Sandip K, George Ralph L, Parulekar Wendy, Thain Kishore, O'Malley Frances, Isotalo Phillip A
Department of Pathology and Molecular Medicine, Kingston General Hospital and Queen's University, Kingston, Ontario, Canada.
Breast J. 2009 Jul-Aug;15(4):409-13. doi: 10.1111/j.1524-4741.2009.00746.x.
Basaloid carcinomas have been documented in various anatomic locations. We describe a primary invasive adenocarcinoma of the nipple with extensive basaloid features that was also associated with squamous cell carcinoma (SCC) in situ and an aggressive behavior. A 69-year-old woman without a history of breast neoplasia presented with right nipple pain. Biopsy of the nipple revealed SCC in situ. One year later, she returned with nipple ulceration. An excisional specimen showed a 1.7 cm nodule composed of invasive sheets and ribbons of basaloid cells with numerous mitoses, extensive tumor necrosis and evidence of glandular differentiation. SCC in situ was present in the overlying epidermis. The differential diagnosis included a primary basaloid adenocarcinoma of the nipple, basal cell carcinoma of the nipple, neuroendocrine carcinoma, melanoma, basaloid variant of adenoid cystic carcinoma and metastatic disease. Immunohistochemical profile of this tumor supported a primary basaloid adenocarcinoma of the nipple. Although the initial sentinel lymph node biopsy was negative, within a year of diagnosis, the patient developed ipsilateral axillary node and pulmonary metastases. To the best of our knowledge, this is the first case of basaloid carcinoma to be documented in this anatomic site.
基底样癌已在多个解剖部位被记录。我们描述了一例具有广泛基底样特征的乳头原发性浸润性腺癌，该肿瘤还伴有原位鳞状细胞癌（SCC）且具有侵袭性。一名无乳腺肿瘤病史的69岁女性因右乳头疼痛就诊。乳头活检显示为原位SCC。一年后，她因乳头溃疡再次就诊。切除标本显示一个1.7 cm的结节，由基底样细胞的浸润性片层和条索组成，有大量核分裂象、广泛的肿瘤坏死以及腺管分化的证据。原位SCC存在于覆盖的表皮中。鉴别诊断包括乳头原发性基底样腺癌、乳头基底细胞癌、神经内分泌癌、黑色素瘤、腺样囊性癌的基底样变体以及转移性疾病。该肿瘤的免疫组化特征支持乳头原发性基底样腺癌。尽管最初的前哨淋巴结活检为阴性，但在诊断后一年内，患者出现同侧腋窝淋巴结和肺转移。据我们所知，这是该解剖部位记录的首例基底样癌病例。
