Weidner N, Levine J D
Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.
Cancer. 1988 Oct 15;62(8):1561-7. doi: 10.1002/1097-0142(19881015)62:8<1561::aid-cncr2820620817>3.0.co;2-z.
Two patients developed nodular, well-circumscribed tumors of the breast, discovered by mammography. They were fibroadenoma-like by gross examination and biphasic by light microscopy, containing both tubular glands and spindled myoid cells. Immunocytochemical studies revealed cytokeratin and S-100 immunoreactivity in both the spindled myoid cells and in the tubuloglandular cells (S-100 was focal in the latter). In addition, the spindled myoid cells were immunoreactive for vimentin but negative for desmin. Ultrastructural studies showed the tubular glands to be composed of luminal epithelial cells focally surrounded by myoepithelial cells, but the stroma contained spindled myoepithelial cells admixed with occasional fibroblasts. The diagnostic term, "adenomyoepithelioma," is appropriate for biphasic tumors having both glandular and myoepitheliomatous differentiation. Although additional experience is necessary to be conclusive regarding the biologic behavior of these unusual lesions, the authors believe the adenomyoepitheliomas described here are benign. They were well circumscribed without invasion of adjacent breast, contained neither mitotic figures nor cytologic atypia, and have not recurred or metastasized (6 and 10 months after removal).
两名患者通过乳腺钼靶检查发现乳房出现边界清晰的结节状肿瘤。大体检查显示为纤维腺瘤样，光镜下呈双相性，包含管状腺体和梭形肌样细胞。免疫细胞化学研究显示，梭形肌样细胞和管状腺细胞中均有细胞角蛋白和S - 100免疫反应性（S - 100在后者中呈局灶性）。此外，梭形肌样细胞波形蛋白免疫反应阳性，但结蛋白免疫反应阴性。超微结构研究显示，管状腺体由管腔上皮细胞组成，局部被肌上皮细胞包围，但间质中含有梭形肌上皮细胞，混有偶尔的成纤维细胞。诊断术语“腺肌上皮瘤”适用于具有腺性和肌上皮瘤样分化的双相性肿瘤。尽管对于这些不寻常病变的生物学行为得出结论还需要更多经验，但作者认为这里描述的腺肌上皮瘤是良性的。它们边界清晰，未侵犯相邻乳腺组织，既无核分裂象也无细胞异型性，且切除后6个月和10个月均未复发或转移。
