Hsieh Min-Shu, Chou Yueh-Hung, Yeh Shin-Joe, Chang Yih-Leong
Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, No 7, Chung-Shan South Road, 100, Taipei, Taiwan.
Virchows Arch. 2015 Aug;467(2):145-53. doi: 10.1007/s00428-015-1786-8. Epub 2015 May 15.
Mammary analogue secretory carcinoma (MASC) has a specific ETV6-NTRK3 translocation and morphologically overlaps with acinic cell carcinoma (AciCC). Before the recognition of MASC, in AciCC, four histologic patterns were identified including microcystic, solid, papillary-cystic, and follicular. The aim of this study was to evaluate histologic patterns in these two neoplasms through comprehensive histologic subtyping. Using fluorescence in situ hybridization (FISH), we identified 14 cases of MASC and 21 cases of AciCC. We used comprehensive histologic subtyping to provide a semiquantitive assessment of histologic patterns in each tumor and performed immunohistochemical analyses including S100/vimentin/mammaglobin/DOG1. MASC often presented papillary-cystic patterns without a solid component, previously considered to be one of the four major patterns associated with AciCC. However, in our study, this histologic feature was rarely seen in AciCC and more characteristic of MASC. In aspiration cytology samples, MASC was associated with more cellular atypia. An immunohistochemical panel of S100/mammaglobin/DOG1 was found useful for differential diagnosis. Comprehensive subtyping of histologic patterns is a useful screening method prior to initiation of molecular testing.
乳腺样分泌性癌（MASC）具有特定的ETV6-NTRK3易位，在形态学上与腺泡细胞癌（AciCC）重叠。在MASC被认识之前，在AciCC中，已确定了四种组织学模式，包括微囊型、实体型、乳头囊型和滤泡型。本研究的目的是通过全面的组织学亚型分类来评估这两种肿瘤的组织学模式。使用荧光原位杂交（FISH），我们鉴定出14例MASC和21例AciCC。我们使用全面的组织学亚型分类对每个肿瘤的组织学模式进行半定量评估，并进行了免疫组织化学分析，包括S100/波形蛋白/乳腺珠蛋白/DOG1。MASC常呈现乳头囊型模式，无实体成分，这一模式以前被认为是与AciCC相关的四种主要模式之一。然而，在我们的研究中，这种组织学特征在AciCC中很少见，而更具MASC的特征性。在细针穿刺细胞学样本中，MASC伴有更多的细胞异型性。发现S100/乳腺珠蛋白/DOG1免疫组织化学组合有助于鉴别诊断。在开始分子检测之前，组织学模式的全面亚型分类是一种有用的筛查方法。
