Mallick Debjani, Aniruna Aniruna, Gon Sonia, Ghosh Gayatri
Dept. of Pathology, ESI PGIMSR& ESIC Medical College, Joka Kolkata, West Bengal, India.
Iran J Pathol. 2016 Spring;11(2):167-70.
Malignant papillary neoplasms of the breast comprise a number of microscopically distinct lesions, where apocrine metaplasia is commonly found in papillomas compared to other papillary lesions including papillary carcinomas. However, association of apocrine metaplasia in papilloma with Ductal Carcinoma in Situ (DCIS) is not very well defined. The lesions with apocrine metaplasia are not only difficult to categories, but also there is controversy regarding their relative risk of subsequent carcinoma development. A case of extensive apocrine differentiation in duct papilloma with DCIS developing in the background of papillomatosis, posing a diagnostic dilemma for the pathologist and a therapeutic challenge for the surgeon, is hereby reported for its uniqueness and rarity. Awareness of this association should be kept in mind by both the pathologist as well as clinician for optimal therapeutic intervention.
乳腺恶性乳头状肿瘤包括一些在显微镜下有明显区别的病变，与其他乳头状病变（包括乳头状癌）相比，大汗腺化生在乳头状瘤中较为常见。然而，乳头状瘤中的大汗腺化生与导管原位癌（DCIS）之间的关联尚未明确界定。伴有大汗腺化生的病变不仅难以分类，而且关于其后续发生癌变的相对风险也存在争议。本文报告了一例在乳头状瘤病背景下发生导管乳头状瘤伴广泛大汗腺分化并发展为DCIS的病例，因其独特性和罕见性，给病理学家带来了诊断难题，也给外科医生带来了治疗挑战。病理学家和临床医生都应牢记这种关联，以便进行最佳的治疗干预。
