Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA.
Ann Diagn Pathol. 2011 Apr;15(2):84-92. doi: 10.1016/j.anndiagpath.2010.08.007. Epub 2010 Dec 16.
Prominent coarse eosinophilic cytoplasmic granules reminiscent of those in intestinal Paneth cells are rarely identified in breast carcinomas. In the literature, this phenomenon seems to be associated with acinic cell carcinoma of the breast or microglandular adenosis-related lesions. In this study, we report 3 breast carcinoma cases with such granules. Two of the cases were carcinomas arising in microglandular adenosis, one of which contained areas of acinic carcinoma-like features. The other case was a mammary carcinoma with prominent microglandular adenosis and also acinic cell carcinoma growth patterns. In the latter case, the patient had a history of neoadjuvant chemotherapy; and cells with coarse granules were found in both the pretreatment and posttreatment specimens. Although all 3 tumors were negative for HER2/neu, 2 tumors were estrogen receptor/progesterone receptor negative and one was estrogen receptor/progesterone receptor positive. Follow-up for 2 patients at 12 months and 3 years showed no evidence of disease, and the other patient died of her disease at 34 months. We provide a review of the literature and conclude that prominent coarse eosinophilic granules are a rare and nonspecific feature in breast epithelium. The clinical significance remains to be investigated, given the limited experience.
在乳腺癌中很少发现类似于肠 Paneth 细胞的粗大嗜酸性细胞质颗粒。在文献中，这种现象似乎与乳腺的浆液性细胞癌或微腺性腺病相关病变有关。在本研究中，我们报告了 3 例具有这种颗粒的乳腺癌病例。其中 2 例为微腺性腺病起源的癌，其中 1 例含有类似浆液性细胞癌特征的区域。另 1 例为伴有明显微腺性腺病和浆液性细胞癌生长模式的乳腺癌。在后一种情况下，患者有新辅助化疗史；在治疗前和治疗后的标本中均发现了具有粗大颗粒的细胞。尽管所有 3 个肿瘤均为 HER2/neu 阴性，但有 2 个肿瘤雌激素受体/孕激素受体阴性，1 个雌激素受体/孕激素受体阳性。对 2 例患者进行了 12 个月和 3 年的随访，均未发现疾病证据，另 1 例患者在 34 个月时死于该病。我们回顾了文献，并得出结论，粗大嗜酸性颗粒是乳腺上皮中罕见且非特异性的特征。鉴于经验有限，其临床意义仍有待研究。
