Takahashi Keiichi, Wakasa Tomoko, Shintaku Masayuki
Takahashi Breast and Gastroenterology Clinic, Osaka, Japan.
Department of Pathology, Osaka Red Cross Hospital, Osaka, Japan.
Asian J Surg. 2017 May;40(3):243-247. doi: 10.1016/j.asjsur.2015.01.009. Epub 2015 Mar 13.
Primary squamous cell carcinoma of the breast (SCCB) is a rare disease, with a worldwide incidence <0.1%. In many cases, it is clinically characterized by rapid growth. Cyst formation due to central necrosis of the tumor accompanies its growth of the tumor in approximately 60-80% of all cases. Furthermore, it is considered difficult to diagnose SCCB solely on the basis of findings from diagnostic imaging. For large intracystic tumors, mammotome biopsy or core needle biopsy (CNB) is rarely performed. Instead, fine-needle aspiration (FNA) targeted at the tumor inside the cyst is often performed. The accurate diagnosis rate of SCCB using FNA is lower than that for ordinary-type breast cancer. If the cyst is large, the solid tumor shadow outside the cyst behind or around the cyst may be masked or hidden by the large cyst, which can sometimes yield an unclear view of the tumor shadow or make it impossible to visualize the shadow. In the present case, the contents within the cyst were completely aspirated and collected during the first step (FNA), thereby yielding a clearer, complete view of the solid tumor located outside the cyst. Thus, the subsequent step (CNB) was able to be performed in a more accurate and reliable manner. The combined use of FNA and CNB proved to be useful in making a preoperative diagnosis of SSCB accompanying a cyst.
原发性乳腺鳞状细胞癌(SCCB)是一种罕见疾病,全球发病率<0.1%。在许多情况下,其临床特征为生长迅速。在所有病例中,约60 - 80%的肿瘤会因中央坏死形成囊肿并随肿瘤生长。此外,仅根据诊断性影像学检查结果很难诊断SCCB。对于大的囊内肿瘤,很少进行麦默通活检或粗针穿刺活检(CNB)。相反,常对囊肿内的肿瘤进行细针穿刺抽吸(FNA)。使用FNA诊断SCCB的准确率低于普通型乳腺癌。如果囊肿较大,囊肿后方或周围囊肿外的实性肿瘤阴影可能会被大囊肿掩盖或隐藏,有时会导致肿瘤阴影显示不清或无法看到阴影。在本病例中,第一步(FNA)就将囊肿内的内容物完全抽吸并收集,从而更清晰、完整地显示了囊肿外的实性肿瘤。因此,后续步骤(CNB)能够以更准确、可靠的方式进行。事实证明,FNA和CNB联合使用有助于对伴有囊肿的SCCB进行术前诊断。