Department of Pathology and Laboratory Medicine, Henry Ford Hospital, Detroit, MI 48202, USA.
Arch Pathol Lab Med. 2013 May;137(5):725-9. doi: 10.5858/arpa.2011-0404-RS.
Adenomyoepithelioma of the breast is an uncommon tumor characterized by dual differentiation into luminal cells and myoepithelial cells. A spectrum of histologic patterns is observed among these tumors and even in different areas of individual tumors. These lesions can be diagnostically challenging, especially when a core needle biopsy is performed, because of the heterogeneity of adenomyoepitheliomas. Recognition of the biphasic cellular elements and the characteristic overall architecture of the tumors in combination with immunohistochemistry are essential to establish the correct diagnosis. Although most tumors have a benign clinical course, local recurrences, malignant transformations, and distant metastases have been reported. All the reported malignant adenomyoepitheliomas with metastases have shown significant cytologic atypia and brisk mitotic rates. Therefore, adequate sampling of the tumor to identify these features is necessary. A complete excision with adequate margins would lower the chance of local recurrence or potential for metastasis.
乳腺腺肌上皮瘤是一种罕见的肿瘤,其特征为向腔上皮细胞和肌上皮细胞的双相分化。在这些肿瘤中观察到一系列组织学模式,甚至在单个肿瘤的不同区域也是如此。由于腺肌上皮瘤的异质性,这些病变在诊断上具有挑战性,特别是在进行核心针活检时。认识到双相细胞成分和肿瘤的特征性整体结构,结合免疫组织化学,对于确立正确的诊断至关重要。尽管大多数肿瘤具有良性的临床过程,但已有局部复发、恶性转化和远处转移的报道。所有报道的有转移的恶性腺肌上皮瘤均表现出明显的细胞异型性和活跃的有丝分裂率。因此,有必要对肿瘤进行充分取样以识别这些特征。完整切除并保证足够的切缘可降低局部复发或潜在转移的机会。