Department of Pathology, University of Yamanashi, Yamanashi, Japan.
J Clin Pathol. 2012 Aug;65(8):699-703. doi: 10.1136/jclinpath-2012-200765. Epub 2012 May 3.
The developmental mechanisms of breast neuroendocrine carcinoma (B-NEC) have not been sufficiently analysed and are not well understood.
To investigate NE cells in the background tissues surrounding B-NECs.
Three cases (four breasts) having many NE cells in the background tissues of multifocal B-NECs were identified at the University of Yamanashi Hospital and St Luke's International Hospital, Japan. These patients were, respectively, 28-, 31- and 38-year-old women with no familial history of NE tumour. The totally-resected breasts were serially studied by immunohistochemistry for specific NE markers (chromogranin A/synaptophysin) and the morphologies and/or localisation of NE cells were investigated.
Immunohistochemical examination showed extensively-distributed NE cells in the background mammary ducts/lobules of the NECs in all breasts. These NE cells were classifiable into three emerging patterns: isolated/scattered, clustered and circumferential. Their distributions were intermingled and were not clearly related to B-NEC foci. NE cells were morphologically polygonal, oval or columnar with sometimes eosinophilic and/or fine-granular cytoplasm and round-to-ovoid nuclei lacking atypia. Some cells were located between epithelial and myoepithelial cells. Apical snouts were occasionally observed in NE cells forming luminal structures.
Benign-appearing NE cells in the parenchyma of a breast with NEC could be regarded as hyperplastic from their emerging patterns and distribution; this NE cell hyperplasia may be associated with the histogenesis of B-NEC as a precancerous condition. These observations might raise questions about the treatment for B-NEC.
乳腺神经内分泌癌（B-NEC）的发育机制尚未得到充分分析，也未得到很好的理解。
研究 B-NEC 周围背景组织中的 NE 细胞。
在日本山梨大学医院和圣卢克国际医院鉴定了 3 例（4 个乳房）多灶性 B-NEC 背景组织中有许多 NE 细胞的病例。这些患者分别为 28 岁、31 岁和 38 岁，均无 NE 肿瘤家族史。对全切除的乳房进行连续免疫组织化学染色，以检测特定的 NE 标志物（嗜铬粒蛋白 A/突触素），并研究 NE 细胞的形态和/或定位。
免疫组织化学检查显示，所有乳房 NEC 背景乳腺导管/小叶中均广泛分布 NE 细胞。这些 NE 细胞可分为三种新出现的模式：孤立/分散、簇状和环状。它们的分布相互交织，与 B-NEC 灶无明显关系。NE 细胞形态为多边形、椭圆形或柱状，有时嗜酸性和/或细颗粒状细胞质，圆形至椭圆形核，无异型性。一些细胞位于上皮细胞和肌上皮细胞之间。NE 细胞偶尔在形成腔结构的顶突处观察到。
从形态和分布上看，NEC 乳房实质中表现为良性的 NE 细胞可视为增生；这种 NE 细胞增生可能与 B-NEC 的组织发生有关，是一种癌前状态。这些观察结果可能引发对 B-NEC 治疗的质疑。
