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乳腺叶状肿瘤:组织病理学特征、鉴别诊断及分子/遗传学新进展

Phyllodes Tumor of the Breast: Histopathologic Features, Differential Diagnosis, and Molecular/Genetic Updates.

作者信息

Zhang Yanhong, Kleer Celina G

机构信息

From the Department of Pathology and Laboratory Medicine, University of California, Davis Medical Center, Sacramento (Dr Zhang); and the Department of Pathology, University of Michigan, Ann Arbor (Dr Kleer).

出版信息

Arch Pathol Lab Med. 2016 Jul;140(7):665-71. doi: 10.5858/arpa.2016-0042-RA.

Abstract

CONTEXT

-Phyllodes tumor (PT) of the breast is a rare fibroepithelial neoplasm with risks of local recurrence and uncommon metastases. The classification proposed by the World Health Organization for PTs into benign, borderline, and malignant is based on a combination of several histologic features. The differential diagnosis between PT and fibroadenoma and the histologic grading of PT remain challenging. In addition, the molecular pathogenesis of PT is largely unknown.

OBJECTIVE

-To provide an updated overview of pathologic features, diagnostic terminology, and molecular alterations of PT.

DATA SOURCES

-Current English literature related to PT of the breast.

CONCLUSIONS

-Phyllodes tumor shows a wide spectrum of morphology. There are no clearly distinct boundaries between PT and fibroadenoma. Strict histologic assessment of a combination of histologic features with classification can help to achieve the correct diagnosis and provide useful clinical information. The genomic landscapes of PT generated from genomic sequencing provide insights into the molecular pathogenesis of PT and help to improve diagnostic accuracy and identify potential drug targets in malignant PT.

摘要

背景

乳腺叶状肿瘤(PT)是一种罕见的纤维上皮性肿瘤,有局部复发和罕见转移的风险。世界卫生组织对PT的分类为良性、交界性和恶性,是基于多种组织学特征的综合。PT与纤维腺瘤的鉴别诊断以及PT的组织学分级仍然具有挑战性。此外,PT的分子发病机制很大程度上尚不清楚。

目的

提供PT的病理特征、诊断术语和分子改变的最新概述。

数据来源

与乳腺PT相关的当前英文文献。

结论

叶状肿瘤表现出广泛的形态学特征。PT与纤维腺瘤之间没有明显的界限。对组织学特征与分类相结合进行严格的组织学评估有助于做出正确诊断并提供有用的临床信息。基因组测序产生的PT基因组图谱为PT的分子发病机制提供了见解,并有助于提高诊断准确性和识别恶性PT中的潜在药物靶点。

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