From the Department of Pathology and Laboratory Medicine, University of Florida, Jacksonville. (Dr Butler), and the Moffitt Cancer Center, Department of Anatomic Pathology, Tampa, Florida (Dr Rosa).
Arch Pathol Lab Med. 2013 Nov;137(11):1688-92. doi: 10.5858/arpa.2012-0603-RS.
Pleomorphic lobular carcinoma is an uncommon variant of lobular carcinoma, characterized by significant cytologic atypia that contrasts with the low pleomorphism of classical lobular carcinoma. It accounts for approximately 1% of all epithelial breast malignancies. In addition to its pleomorphism, it is characterized by aggressive behavior and shortened patient survival. Although the morphologic features of pleomorphic lobular carcinoma are well described, it often eludes accurate pathologic characterization. Some controversy surrounds the pathogenesis of pleomorphic lobular carcinoma; however, it is now considered a well-defined variant of invasive lobular carcinoma. Pleomorphic lobular carcinoma shares molecular alterations with classical lobular carcinoma, such as alterations in the gene CDH1 on chromosome band 16q22 that results in changes in E-cadherin protein function. The aggressive biology of pleomorphic lobular carcinoma relates to the acquisition of genetic alterations typical of high-grade ductal carcinoma, such as overexpression of HER2/neu and c-myc.
多形性小叶癌是小叶癌的一种不常见变异型，其特征为显著的细胞学异型性，与经典小叶癌的低异型性形成对比。它约占所有上皮性乳腺恶性肿瘤的 1%。除了多形性之外，它还具有侵袭性行为和缩短患者生存时间的特点。尽管多形性小叶癌的形态特征已有详细描述，但它常常难以准确进行病理特征描述。关于多形性小叶癌的发病机制存在一些争议；然而，它现在被认为是浸润性小叶癌的一种明确变异型。多形性小叶癌与经典小叶癌具有相同的分子改变，例如染色体 16q22 带上 CDH1 基因的改变导致 E-钙黏蛋白蛋白功能的改变。多形性小叶癌侵袭性生物学与获得典型的高级别导管癌的遗传改变有关，例如 HER2/neu 和 c-myc 的过度表达。
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