Kim Hye Min, Kim Eun Kyung, Koo Ja Seung
Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
J Pathol Transl Med. 2017 Mar;51(2):176-179. doi: 10.4132/jptm.2016.08.17. Epub 2016 Dec 5.
Breast cancers that present with mucin include mucinous carcinoma and carcinoma with signet ring cell differentiation. The former shows extracellular mucin and the latter shows abundant intracellular mucin. Here, we report a case of breast cancer showing both extracellular mucin and extensive signet ring cell differentiation due to abundant intracellular mucin. Unlike mucinous carcinoma, this case had the features of high-grade nuclear pleomorphism, high mitotic index, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor-2 positivity, and ductal type with positivity for E-cadherin. In a case with signet ring cell differentiation, differential diagnosis with metastatic signet ring cell carcinoma of the stomach and colon is essential. In this case, the presence of accompanied ductal carcinoma component and mammaglobin and gross cystic disease fluid protein-15 positivity were findings that suggested the breast as the origin.
伴有黏液的乳腺癌包括黏液癌和具有印戒细胞分化的癌。前者表现为细胞外黏液，后者表现为丰富的细胞内黏液。在此，我们报告一例乳腺癌，该病例既有细胞外黏液，又因丰富的细胞内黏液而具有广泛的印戒细胞分化。与黏液癌不同，该病例具有高级别核多形性、高有丝分裂指数、雌激素受体阴性、孕激素受体阴性、人表皮生长因子受体-2阳性以及E-钙黏蛋白阳性的导管型特征。在伴有印戒细胞分化的病例中，与胃和结肠转移性印戒细胞癌的鉴别诊断至关重要。在本病例中，伴有导管癌成分以及乳腺珠蛋白和巨大囊肿病液体蛋白-15阳性是提示起源于乳腺的发现。
