Foschini Maria P, Asioli Sofia, Foreid Susan, Cserni Gabor, Ellis Ian O, Eusebi Vincenzo, Rosai Juan
*Department of Biomedical and Neuromotor Sciences, Section of Pathology "M. Malpighi," University of Bologna, Bologna ∥Department of Pathology, CDI, Milano, Italy †Pathology Unit, Laboratories Dr. Macedo Dias, Porto, Portugal ‡Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary §Department of Histopathology, Nottingham City Hospital, Nottingham, United Kingdom.
Am J Surg Pathol. 2017 Jul;41(7):887-895. doi: 10.1097/PAS.0000000000000853.
Thirteen cases of invasive solid papillary breast carcinomas resembling the tall cell variant of papillary thyroid neoplasms (BPTC) are reported here. Some cases had long-term follow-up. BPTC is a special type of primary breast neoplasm showing a triple-negative profile but low aggressive potential. Knowledge on BPTC is still scanty; therefore, the aim of the present paper was to report on the features of an additional 13 cases. All the patients were female individuals, and the mean age at presentation was 62.6 years; nodule sizes ranged from 0.6 to 2.5 cm (average, 1.6 cm). All the cases were characterized on histology by papillary, follicular as well as solid structures. The cells were columnar, eosinophilic mostly with granular cytoplasms, rich in mitochondria, with the features of oncocytes in no fewer than 7 cases. Estrogen and progesterone receptors as well as HER2 were consistently negative. The Ki67 proliferative index was low. Markers consistent with thyroid origin, such as TTF1 and thyroglobulin, were negative. Five cases stained for mammoglobin and GATA 3 were positive. All cases proved to be invasive and 2 cases each experienced metastases to 1 lymph node (axillary and intramammary). One case of the latter had a local recurrence. Nevertheless, all the patients are alive, free of disease 24 to 132 months after surgery, of which 8 are without further treatment The present series confirms that BPTC is a primary breast tumor of low malignant potential.
本文报告了13例侵袭性实性乳头状乳腺癌，其类似于甲状腺乳头状肿瘤的高细胞变体（BPTC）。部分病例进行了长期随访。BPTC是一种特殊类型的原发性乳腺肿瘤，呈三阴性特征但侵袭潜能较低。目前关于BPTC的知识仍然匮乏；因此，本文旨在报告另外13例病例的特征。所有患者均为女性，就诊时的平均年龄为62.6岁；结节大小范围为0.6至2.5厘米（平均1.6厘米）。所有病例在组织学上均具有乳头状、滤泡状以及实性结构。细胞呈柱状，大多为嗜酸性，细胞质颗粒状，富含线粒体，至少7例具有嗜酸性细胞的特征。雌激素和孕激素受体以及HER2均持续呈阴性。Ki67增殖指数较低。与甲状腺起源相关的标志物，如TTF1和甲状腺球蛋白，均为阴性。5例乳腺珠蛋白和GATA 3染色呈阳性。所有病例均证实为侵袭性，各有2例发生转移至1个淋巴结（腋窝和乳腺内）。后者中有1例出现局部复发。然而，所有患者均存活，术后24至132个月无疾病，其中8例未接受进一步治疗。本系列研究证实BPTC是一种低恶性潜能的原发性乳腺肿瘤。
