D'Antonio Antonio, Addesso Maria, Memoli Domenico, Cascone Annamaria, Cremone Luigi
Department of Pathologic Anatomy A.O.U. S. Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.
Unit of Pathologic Anatomy, ASL Salerno, Hospital Tortora, Pagani (SA), Italy.
Breast Dis. 2016;36(4):161-164. doi: 10.3233/BD-160226.
Neuroendocrine features are detectable in carcinomas of the breast either as scattered cells, that are recognized by their expression of neuroendocrine cell markers. Instead, pure breast carcinomas with neuroendocrine features (NEBC) are very rare and represent <1% of all breast cancer. Usually NEBC may be well or poorly differentiated and more frequent in older woman. These tumors showed variable histological pattern but a common feature is represented by expression of neuroendocrine markers. Here we report a case of a primary multicentric low-grade neuroendocrine carcinoma of the breast presented because of its rarity and for the unusual tubular and cribriform pattern resembling a well-differentiated conventional breast carcinoma. The tumor was treated with left quadrantectomy with concomitant wide excisional biopsy of other two nodules and lymph node sentinel biopsy. No recurrence was observed during 1-year follow-up. Because of its rarity and variability of morphologic features, there exist diagnostic challenges for pathologists to differentiate primary NEBC to some conventional breast carcinomas and to the breast metastasis from neuroendocrine tumor of the lung or gastrointestinal tract. It is important to be able recognize this tumor in order to avoid potential misdiagnosis and improper management of afflicted patients.
神经内分泌特征在乳腺癌中可表现为散在细胞,这些细胞可通过神经内分泌细胞标志物的表达得以识别。相反,具有神经内分泌特征的纯乳腺癌(NEBC)非常罕见,占所有乳腺癌的比例不到1%。通常,NEBC的分化程度可高可低,在老年女性中更为常见。这些肿瘤具有多种组织学模式,但共同特征是神经内分泌标志物的表达。在此,我们报告一例原发性多中心低级别乳腺神经内分泌癌病例,因其罕见性以及类似高分化传统乳腺癌的不寻常管状和筛状模式而呈现。该肿瘤接受了左象限切除术,并同时对另外两个结节进行了广泛切除活检以及前哨淋巴结活检。在1年的随访期间未观察到复发。由于其罕见性和形态学特征的多样性,病理学家在将原发性NEBC与某些传统乳腺癌以及肺或胃肠道神经内分泌肿瘤的乳腺转移瘤进行鉴别诊断时面临挑战。能够识别这种肿瘤很重要,以避免对患病患者的潜在误诊和不当治疗。