Cha Yoon Jin, Kim Gi Jeong, Park Byeong-Woo, Koo Ja Seung
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
Department of General Surgery, Yonsei University College of Medicine, Seoul, Korea.
Korean J Pathol. 2014 Jun;48(3):229-33. doi: 10.4132/KoreanJPathol.2014.48.3.229. Epub 2014 Jun 26.
This paper reports a case of low-grade adenosquamous carcinoma (LGASC) arising in a 69-year-old woman, who presented with a 1-cm palpable mass on her right breast. Core needle biopsy diagnosed the mass as a fibroadenoma. After six months, the mass increased in size, and the patient received subsequent mammotome excision. On microscopic examination, bland-looking small glands were infiltrating into the fibrotic stroma with lymphocytic infiltrates at the periphery. Hematoxylin and eosin staining revealed relatively easily detectable myoepithelial cells along the outside in each of the glandular structures with variable degrees of squamous metaplasia. Based on histologic features, the patient was diagnosed with LGASC. LGASC is a rare variant of metaplastic carcinoma, which is characterized by a favorable prognosis. Due to the bland cytology and presence of myoepithelial cells, LGASC can be misdiagnosed as benign lesion. Additionally, inconsistent expression of myoepithelial markers could aid the diagnosis of LGASC.
本文报告了一例发生在一名69岁女性身上的低级别腺鳞癌(LGASC),该患者右乳出现一个可触及的1厘米肿块。粗针活检将该肿块诊断为纤维腺瘤。六个月后,肿块增大,患者接受了后续的麦默通切除术。显微镜检查显示,外观温和的小腺体浸润到纤维化间质中,周边有淋巴细胞浸润。苏木精和伊红染色显示,在每个腺结构的外侧相对容易检测到肌上皮细胞,伴有不同程度的鳞状化生。根据组织学特征,该患者被诊断为LGASC。LGASC是化生性癌的一种罕见变体,其特点是预后良好。由于细胞形态温和且存在肌上皮细胞,LGASC可能被误诊为良性病变。此外,肌上皮标志物的表达不一致有助于LGASC的诊断。