Breast Health Unit, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel.
Department of Pathology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel.
Mod Pathol. 2018 Jan;31(1):62-67. doi: 10.1038/modpathol.2017.96. Epub 2017 Aug 11.
The use of hygroscopic sonographically detectable clips (HSDCs) has dramatically increased during the last years, especially in breast cancer patients who undergo neoadjuvant chemotherapy. The aims of this study are to define the appearance of HSDC sites in histopathological specimens, and to enable pathologists to recognize these sites and differentiate them from other lesions. We examined 124 breast cancer specimens in which the application of HSDCs was documented, 88 breast tissues and 36 lymph nodes, and analyzed the appearance of the clip site in these tissues. The clip site was clearly detected histologically in 79/88 (90%) of the breast specimens and in 29/36 (81%) of lymph node specimens. In most of the specimens, the HSDC site had a specific characteristic appearance of a pseudocyst, lined by layers of epithelioid histiocytes, sometimes with pseudopapillary formation, and with minimal or no fibrosis. This was the appearance in 69 of the breast specimens and in 23 of the lymph node specimens. In other specimens, scarring, scattered foamy macrophages and abundant siderophages were the predominant findings, as usually found in sites of other clips. As non-palpable breast lesions become more frequent, clips play a major role in the treatment of breast cancer, making them an important component of the communication among radiologists, surgeons, pathologists, and oncologists. HSDCs in tissues have a characteristic appearance with an epithelioid component. Pathologists should be able to recognize this finding, differentiate it from other breast lesions and include it in the pathology report.
近年来，吸湿超声可见夹（HSDC）的使用显著增加，尤其是在接受新辅助化疗的乳腺癌患者中。本研究的目的是定义 HSDC 部位在组织病理学标本中的外观，并使病理学家能够识别这些部位并将其与其他病变区分开来。我们检查了 124 例记录了 HSDC 应用的乳腺癌标本、88 例乳腺组织和 36 例淋巴结，并分析了这些组织中夹部位的外观。在 79/88（90%）例乳腺标本和 29/36（81%）例淋巴结标本中，夹部位在组织学上清晰可辨。在大多数标本中，HSDC 部位具有特定的假性囊肿样特征性外观，由上皮样组织细胞层排列，有时伴有假乳头状形成，且纤维化最小或无。69 例乳腺标本和 23 例淋巴结标本均有此表现。在其他标本中，瘢痕、散在泡沫状巨噬细胞和丰富的含铁血黄素细胞是主要发现，如在其他夹部位通常发现的那样。随着不可触及的乳腺病变变得更加频繁，夹在乳腺癌的治疗中起着重要作用，使其成为放射科医生、外科医生、病理学家和肿瘤学家之间沟通的重要组成部分。组织中的 HSDC 具有上皮样成分的特征性外观。病理学家应该能够识别这种发现，将其与其他乳腺病变区分开来，并将其包含在病理报告中。
