Yamaguchi Rin, Tanaka Maki, Yamaguchi Miki, Fukushima Takanaru, Kaneko Yuko, Otsuka Hiroko, Isobe Shin, Terasaki Hiroshi, Nakashima Osamu, Kage Masayoshi, Yano Hirohisa
Department of Pathology, Kurume University Medical Center, Kurume, Japan.
Med Mol Morphol. 2010 Mar;43(1):43-7. doi: 10.1007/s00795-009-0468-5. Epub 2010 Mar 26.
We report a 17-year-old woman with refractory high-grade breast cancer who died early after surgery, with reference to the histogenesis of the cancer. Macroscopically, the tumor was cystic, composed of a mixture of solid and myxomatous areas. Histologically, the tumor exhibited ductal structures and areas with squamoid features. Cancer cells were markedly atypical and polymorphic, and included a mixture of bizarre and eosinophilic cells with rhabdoid feature-like free cells. Immunohistochemically, cytokeratin (CK) 8, CK 18, 34 beta E12, CD10, involucrin, CK14, and vimentin were partially positive, whereas estrogen and progesterone receptors and HER-2 were negative. These findings suggest an undifferentiated cancer whose cells have multilineage potential to differentiate into mesenchymal, basal, and squamoid cells, and it was diagnosed as pleomorphic carcinoma, which is a histological type hitherto unreported in young girls. The cancer was refractory to treatment, and the patient died 1 year and 5 months after surgery despite chemotherapy and radiotherapy.
我们报告了一名17岁患有难治性高级别乳腺癌的女性,她在手术后不久死亡,并参考了该癌症的组织发生学。大体上,肿瘤呈囊性,由实性和黏液样区域混合组成。组织学上,肿瘤呈现导管结构以及具有鳞状特征的区域。癌细胞明显异型且多形,包括奇异型和嗜酸性细胞的混合物以及具有横纹肌样特征的游离细胞。免疫组化方面,细胞角蛋白(CK)8、CK 18、34βE12、CD10、内披蛋白、CK14和波形蛋白部分呈阳性,而雌激素和孕激素受体以及HER-2呈阴性。这些发现提示这是一种未分化癌,其细胞具有向间充质、基底和鳞状细胞分化的多谱系潜能,被诊断为多形性癌,这是一种迄今在年轻女孩中未报道过的组织学类型。该癌症对治疗难治,尽管进行了化疗和放疗,患者仍在手术后1年零5个月死亡。