Cuk Mirjana, Gajanin Radoslav, Malis Milos, Erić Drazan, Lalović Nenad, Marić Helena
Univerzitetska bolnica u Foci, Sluzba za patologiju i citodijagnostiku
Med Pregl. 2013 Jan-Feb;66(1-2):86-91. doi: 10.2298/mpns1302086c.
This paper presents two cases of very rare tumors of breast: breast sebaceos carcinoma, which has rarely been described in medical literature, and breast carcinosarcoma. Morphological characteristics and biological behavior of sebaceos carcinoma are still rather vague. Carcinosarcoma of the breast is a rare malignancy with distinct cell lines described as a breast carcinoma of ductal type with a sarcoma-like component.
The first presented case is a 73-year-old female referred to our hospital in January 2008 with tumor of the right breast in the upper outer region of the breast and enlarged lymph nodes in the right axillary region. The second presented case is a 51-year-old female with carcinosarcoma, also a very rare primary breast tumor. She was admitted to our hospital in June 2011 with history of lump in the upper and lower outer quadrant of the left breast. In both cases, biopsy of tumor tissue was carried out with a thin needle, i.e. the aspiration cytology was applied as a diagnostic method, and during the operation the fast diagnostics of frozen sections and cytologic diagnostics were done. Although this methodology is important in diagnosis, in both cases it showed certain limitations in diagnosing such rare tumors. The final diagnosis was made after carefully synthesizing the histological findings and immunohistochemical phenotype.
An accurate classification of breast tumors on cytological preparations is not possible in case of poorly differentiated and rare tumors. A careful and accurate classification of these tumors is necessary.
本文介绍了两例非常罕见的乳腺肿瘤病例:乳腺皮脂腺癌,医学文献中对此鲜有描述,以及乳腺癌肉瘤。皮脂腺癌的形态学特征和生物学行为仍相当模糊。乳腺癌肉瘤是一种罕见的恶性肿瘤,具有不同的细胞系,被描述为具有肉瘤样成分的导管型乳腺癌。
首例病例为一名73岁女性,于2008年1月转诊至我院,其右乳外上象限有肿瘤,右腋窝淋巴结肿大。第二例病例为一名51岁女性,患有癌肉瘤,这也是一种非常罕见的原发性乳腺肿瘤。她于2011年6月因左乳外上象限和外下象限有肿块病史入院。在这两例病例中,均采用细针进行肿瘤组织活检,即应用针吸细胞学作为诊断方法,手术过程中进行了冰冻切片快速诊断和细胞学诊断。尽管这种方法在诊断中很重要,但在这两例病例中,它在诊断此类罕见肿瘤时都显示出一定的局限性。最终诊断是在仔细综合组织学检查结果和免疫组化表型后做出的。
对于低分化和罕见的肿瘤,在细胞学涂片上无法对乳腺肿瘤进行准确分类。对这些肿瘤进行仔细准确的分类是必要的。