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男性乳腺细胞性肌纤维母细胞瘤伴丰富网状纤维:病例报告。

Male breast cellular myofibroblastoma with a rich reticulinic network: case report.

机构信息

University of Medicine and Pharmacy, Targu-Mures, Romania.

出版信息

Am J Mens Health. 2012 Jul;6(4):344-8. doi: 10.1177/1557988312441817. Epub 2012 Mar 19.

Abstract

Myofibroblastoma is a rare mesenchymal tumor located not only in breast but also in extramammary sites. This is the 79th case of breast myofibroblastoma reported in the literature. This tumor presents a great variety of morphological features, which increase the difficulty of differential diagnosis. The authors report a breast myofibroblastoma diagnosed in a 73-year-old male. The article discusses a bilateral gynecomastia and a palpable right breast well-defined tumor, without calcifications on mammography, which was surgically removed. Macroscopically, a well-circumscribed uncapsulated nodule was seen with lobular arrangement on cut section, and microscopically, a nodule with pushing borders and a connective pseudocapsule was seen. The spindle cells were arranged in fascicular clusters, with focally collagen bundles and a rich reticulinic network stained black with Gömöri impregnation. Immunohistochemically, the tumor cells were marked by vimentin, CD34, desmin, and smooth muscle antigen and did not express cytokeratin, S-100 protein, CD99, CD10, and factor VIII-related antigen. More than 90% of the cells expressed estrogen receptor. No recurrences were reported 2 years after surgical excision. This case is a variant of cellular myofibroblastoma, with a rich reticulinic network and scanty collagen bands.

摘要

肌纤维母细胞瘤是一种罕见的间叶性肿瘤,不仅位于乳腺,还位于乳腺外部位。这是文献中报道的第 79 例乳腺肌纤维母细胞瘤。该肿瘤具有多种形态学特征,这增加了鉴别诊断的难度。作者报告了一例 73 岁男性的乳腺肌纤维母细胞瘤。本文讨论了双侧男性乳房发育和可触及的右侧乳腺界限清楚的肿瘤,乳腺 X 线照相术未见钙化,该肿瘤已被手术切除。大体上,可见边界清楚的无包膜小结节,切面呈小叶状排列,显微镜下,可见边界推挤的小结节和结缔组织假包膜。梭形细胞呈束状簇状排列,局灶性胶原束和丰富的网状纤维用 Gömöri 浸染染成黑色。免疫组织化学染色显示,肿瘤细胞标记为波形蛋白、CD34、结蛋白和平滑肌抗原,不表达细胞角蛋白、S-100 蛋白、CD99、CD10 和因子 VIII 相关抗原。超过 90%的细胞表达雌激素受体。手术切除 2 年后无复发报告。该病例是一种富含网状纤维和少量胶原带的细胞性肌纤维母细胞瘤。

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