Okamoto T
Department of Pathology, Fukuyama National Hospital, Japan.
Acta Pathol Jpn. 1989 Jul;39(7):469-72. doi: 10.1111/j.1440-1827.1989.tb02464.x.
An autopsy case of glycogen-rich clear cell carcinoma (GRCCC) which arose in the right breast of a 72-year-old woman is reported. Light microscopic examination of the small finger-tip-sized tumor revealed solid alveolar proliferation of clear cells containing abundant glycogen. Immunohistochemically, most of the clear tumor cells were stained for epithelial membrane antigen (EMA) and alpha-lactalbumin, whereas a few eosinophilic tumor cells were positive for S-100 protein, EMA and actin. Electron microscopically, aggregates of glycogen particles, numerous empty glycogen lakes, microvilli, tight junctions and basal lamina were identified. Autopsy disclosed marked metastases to the liver, lung, adrenal, skin and lymph nodes. Primary breast cancer was confirmed by exclusion of a primary at any other site. It is suggested that although rare, GRCCC of the breast is as aggressive as usual invasive ductal carcinoma, and is associated with severe nodal and blood-borne metastases, followed by death.
报告了一例发生于一名72岁女性右乳的富含糖原的透明细胞癌（GRCCC）尸检病例。对指尖大小的肿瘤进行光镜检查，发现含有丰富糖原的透明细胞呈实性肺泡样增生。免疫组化显示，大多数透明肿瘤细胞上皮膜抗原（EMA）和α-乳白蛋白染色阳性，而少数嗜酸性肿瘤细胞S-100蛋白、EMA和肌动蛋白阳性。电镜检查发现糖原颗粒聚集体、大量空的糖原湖、微绒毛、紧密连接和基膜。尸检发现肝脏、肺、肾上腺、皮肤和淋巴结有明显转移。通过排除其他部位的原发肿瘤，确诊为原发性乳腺癌。提示乳腺GRCCC虽然罕见，但与常见的浸润性导管癌一样具有侵袭性，且伴有严重的淋巴结和血行转移，随后导致死亡。
