Cross A S, Azzopardi J G, Krausz T, van Noorden S, Polak J M
Histopathology. 1985 Jan;9(1):21-37. doi: 10.1111/j.1365-2559.1985.tb02968.x.
Because so-called 'carcinoid' tumour of the breast has proven to be a difficult entity to define, we studied in-situ carcinoma as there were reasons to believe that this might help clarify the complex problems involved. We studied a consecutive series of 30 cases of ductal carcinoma in-situ (DCIS) by light microscopy and silver impregnation methods and identified a relatively common endocrine variant of DCIS. This variant was studied by immunocytochemical and ultrastructural methods, using conventional DCIS as a control. Endocrine DCIS is identified by its organoid pattern, stromal 'inclusions', festooned structure and a distinctive type of polypoid invagination. It is argyrophilic and rich in neuron-specific enolase. Ultrastructurally it contains abundant dense core granules which are impregnated selectively by Grimelius' method. This tumour type frequently contains peptide hormones of the ACTH family. Three of seven cases contained cells reactive for ACTH and corticotropin-like intermediate lobe peptide CLIP or their precursor, pro-opiomelanocortin. A fourth tumour contained neurotensin, recently identified in a variety of endocrine tumours. Argyrophil invasive carcinomas are a much more heterogeneous group of tumours than argyrophil DCIS and only a minority have an endocrine structure comparable to that described here.
由于乳腺所谓的“类癌”肿瘤已被证明是一个难以定义的实体，鉴于有理由相信原位癌可能有助于阐明其中涉及的复杂问题，我们对其进行了研究。我们通过光学显微镜和银浸染法对连续的30例导管原位癌（DCIS）病例进行了研究，并确定了一种相对常见的DCIS内分泌变异型。以传统DCIS作为对照，采用免疫细胞化学和超微结构方法对该变异型进行了研究。内分泌型DCIS通过其器官样结构、间质“包涵体”、花彩状结构和一种独特类型的息肉样内陷得以识别。它嗜银且富含神经元特异性烯醇化酶。超微结构上，它含有丰富的致密核心颗粒，这些颗粒可通过格里梅利乌斯方法进行选择性浸染。这种肿瘤类型常含有促肾上腺皮质激素（ACTH）家族的肽类激素。7例病例中有3例含有对ACTH和促肾上腺皮质激素样中叶肽（CLIP）或其前体阿黑皮素原呈反应性的细胞。第四例肿瘤含有神经降压素，最近在多种内分泌肿瘤中被发现。嗜银性浸润性癌是一组比嗜银性DCIS更为异质性的肿瘤，只有少数具有与本文所述类似的内分泌结构。
