Aillet G, Fiks M, Guillard Y, Gaillard F, Barbin J G, Auger J J, Le Bodic M F
Laboratoire d'Anatomie Pathologique B, Hôpital Nord, Nantes.
Ann Pathol. 1987;7(4-5):325-9.
Three to 5% of breast carcinomas are argyrophilic, including some which are mucinous and thus "composite", whereas there are no argyrophilic cells in normal breast nor in benign breast pathology. This raises the problem of the origin and type of these argyrophilic cells. We carried out a histologic and immunohistochemical study in 4 such cases of mucoid tumors containing at least 50% argyrophilic cells. Two of these tumors presenting node involvement were also studied immunohistochemically. The histologic study showed colloid and intragalactophoric proliferation areas in cell cases and some endocrine areas in 2 out of 4 cases. Argyrophilic cells were present in all of these areas. True mucoargyrophilic amphicrine cells were found primarily in colloid areas. None of these tumors were argentaffin. Immunohistochemical study was performed by the PAP method using antibody directed against VIP, ACTH, PP, somatostatin, bombesin, calcitonin, gastrin, prolactin and GH. Three out of four tumors were positive with VIP. Moreover one of them contained ACTH cells and a metastasis of this tumor contained bombesin cells. No tumor was positive with the other anti-sera tested. This study is related to the rare series in the literature which report secretion of ACTH, catecholamins, bombesin, gastrin, VIP, PP, somatostatin, prolactin, etc. The number of cases reported to date remains too low to show a significant prognostic difference between amphicrine tumors and other mammary carcinomas.
3%至5%的乳腺癌具有嗜银性,其中包括一些黏液性(即“混合性”)肿瘤,而正常乳腺组织及乳腺良性病变中均不存在嗜银细胞。这就引出了这些嗜银细胞的起源及类型问题。我们对4例黏液样肿瘤(嗜银细胞至少占50%)进行了组织学和免疫组化研究。对其中2例伴有淋巴结转移的肿瘤也进行了免疫组化研究。组织学研究显示,所有病例均有胶体和乳管内增生区域,4例中有2例存在一些内分泌区域。所有这些区域均有嗜银细胞。真正的黏液嗜银双分泌细胞主要见于胶体区域。这些肿瘤均无嗜银反应。免疫组化研究采用PAP法,使用针对血管活性肠肽(VIP)、促肾上腺皮质激素(ACTH)、胰多肽(PP)、生长抑素、蛙皮素、降钙素、胃泌素、催乳素和生长激素的抗体。4例肿瘤中有3例对VIP呈阳性反应。此外,其中1例含有ACTH细胞,该肿瘤的1处转移灶含有蛙皮素细胞。其他检测的抗血清均未使肿瘤呈阳性反应。本研究与文献中罕见的系列报道相关,这些报道涉及ACTH、儿茶酚胺、蛙皮素、胃泌素、VIP、PP、生长抑素、催乳素等的分泌。迄今为止报道的病例数量仍然太少,无法显示双分泌肿瘤与其他乳腺癌之间存在显著的预后差异。