Breast Pathology Laboratory, School of Medicine, Federal University of Minas Gerais (UFMG), Av, Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais, 30130-100, Brazil.
Diagn Pathol. 2013 Jul 9;8:114. doi: 10.1186/1746-1596-8-114.
The distinction between lobular neoplasia of the breast and ductal carcinoma in situ has important therapeutic implications. In some cases, it is very difficult to determine whether the morphology of the lesion is ductal or lobular. The aim of this study was to evaluate the value of E-cadherin and β-catenin expression through the immunophenotypical characterization of carcinoma in situ with mixed pattern (CISM).
A total of 25 cases of CISM were analyzed considering cytology/mixed architecture (ductal and lobular), nuclear pleomorphism, loss of cell cohesion, and presence of comedonecrosis. The immunophenotype pattern was considered E-cadherin positive and β-catenin positive, or negative.
Nineteen (76%) cases presented a mixed cytology and / or architectural pattern, two (8%) presented nuclear pleomorphism, two (8%) presented mixed cytology and nuclear pleomorphism, and two (8%) presented comedonecrosis and nuclear pleomorphism. A complete positivity for E-cadherin and β-catenin was observed in 11 cases (44%). In one case, the lesion was negative for both markers and showed nuclear pleomorphis. Thirteen lesions showed negative staining in areas of lobular cytology and positive staining in cells presenting the ductal pattern.
The expression of E-cadherin and β-catenin, combined with cytological and architectural analysis, may highlight different immunophenotypes and improve classification of CISM.
The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/ 1693384202970681
乳腺小叶肿瘤和导管原位癌的鉴别具有重要的治疗意义。在某些情况下，确定病变的形态是导管性还是小叶性非常困难。本研究旨在通过混合模式（CISM）的原位癌免疫表型特征评估 E-钙黏蛋白和β-连环蛋白表达的价值。
共分析了 25 例 CISM，考虑细胞学/混合结构（导管和小叶）、核多形性、细胞黏附丧失和出现粉刺样坏死。免疫表型模式被认为是 E-钙黏蛋白阳性和β-连环蛋白阳性或阴性。
19 例（76%）表现为混合细胞学和/或结构模式，2 例（8%）表现为核多形性，2 例（8%）表现为混合细胞学和核多形性，2 例（8%）表现为粉刺样坏死和核多形性。11 例（44%）完全阳性表达 E-钙黏蛋白和β-连环蛋白。1 例病变两种标志物均为阴性，且核多形性。13 例病变小叶细胞学区域呈阴性染色，呈导管样的细胞呈阳性染色。
E-钙黏蛋白和β-连环蛋白的表达，结合细胞学和结构分析，可能突出不同的免疫表型，改善 CISM 的分类。
