Sun Xiangjie, Zuo Ke, Huang Dan, Yu Baohua, Cheng Yufan, Yang Wentao
Department of Pathology, Fudan University Shanghai Cancer Center, No.2 building, 270 Dong'an Road, Shanghai, 200032, China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Diagn Pathol. 2017 Jul 11;12(1):52. doi: 10.1186/s13000-017-0641-4.
Invasive pleomorphic lobular carcinoma (PLC) is an aggressive subtype of invasive lobular carcinoma of the breast, which has its own histopathological and biological features. The metastatic patterns for PLC are distinct from those of invasive ductal carcinoma. In addition, pancreatic metastasis from PLC is extremely rare.
We report a rare case of a 48-year-old woman presenting with clinical gastrointestinal symptoms and pancreatic metastasis of PLC. The pancreatic tumor was composed of pleomorphic tumor cells arranged in the form of solid sheets and nests and as single files, with frequent mitotic figures, nucleolar prominence, high nuclear to cytoplasmic ratio and loss of cohesion. The malignant cells were positive for p120 (cytoplasmic) and GATA3 and negative for estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, E-cadherin, gross cystic disease fluid protein 15 and mammaglobin, which indicated a lobular carcinoma phenotype of the breast.
To the best of our knowledge, this is one of the few reported cases in the literature of pancreatic metastasis of invasive lobular carcinoma of the breast, of which the definitive diagnosis was obtained only after surgery. Rare metastasis sites should be considered, particularly, when a patient has a medical history of PLC.
浸润性多形性小叶癌（PLC）是乳腺浸润性小叶癌的一种侵袭性亚型，有其自身的组织病理学和生物学特征。PLC的转移模式与浸润性导管癌不同。此外，PLC发生胰腺转移极为罕见。
我们报告一例罕见病例，一名48岁女性，表现出临床胃肠道症状且患有PLC胰腺转移。胰腺肿瘤由多形性肿瘤细胞组成，呈实性片状、巢状及单行排列，有频繁的有丝分裂象、核仁显著、核质比高及细胞间黏附丧失。恶性细胞p120（细胞质）和GATA3呈阳性，雌激素受体、孕激素受体、人表皮生长因子受体2、E-钙黏蛋白、巨大囊肿病液体蛋白15和乳腺珠蛋白呈阴性，提示为乳腺小叶癌表型。
据我们所知，这是文献中报道的少数乳腺浸润性小叶癌胰腺转移病例之一，其中仅在手术后才获得明确诊断。当患者有PLC病史时，应考虑罕见的转移部位。
