Wu Hai-Bo, Zhang An-Li, Wang Wei, Li Heng
aDepartment of Pathology, Southern District of Anhui Provincial Hospital bLaboratory of Cancer Genomics and Epigenetics, High Magnetic Field Laboratory of the Chinese Academy of Sciences, Hefei, Anhui, China.
Medicine (Baltimore). 2017 Nov;96(46):e8785. doi: 10.1097/MD.0000000000008785.
Low-grade adenosquamous carcinoma (LGASC) is a rare subtype of metaplastic breast carcinoma which is generally recognized as a characteristic subgroup of triple-negative breast cancers previously. However, in this study, we reported for the first time a case of LGASC with hormone receptors expression.
Pathological analysis of breast tumor specimen obtained by a 42-year-old female patient was performed. Morphologically, it composed of glandular structures with scattered squamous differentiation accompanied by haphazard arrangement of spindle cell stroma. Immunohistochemically, all myoepithelial and squamous differentiation markers showed typical LGASC positive or negative staining pattern. Interestingly, we found that normally aberrant hormone receptors were reactivated in this case. To our knowledge, this is the first report of a hormone receptor-positive LGASC. Apart from this, in the extended resection sample, we found scattered squamous metaplasia and florid adenosquamous proliferation (ASP). Meanwhile, it was positive for CD44 variant isoforms (CD44v), which is a breast cancer stem cell (CSC) marker, and expressed in LGASC, squamous metaplasia, and ASP.
LGASC with hormone receptors expression.
The breast-extended local excision and axillary lymph node dissection were performed.
The patient was free of local recurrence and distant metastasis 6 months after surgical resection.
We herein report the first case of LGASC with immunoreactivity for hormone receptors, expanding its profile of immunophenotypes. CD44v may play an important role in the transition of LGASC precursor lesions into malignant processes, which may serve as a therapeutic target in LGASC.
低级别腺鳞癌（LGASC）是一种罕见的化生性乳腺癌亚型，此前通常被认为是三阴性乳腺癌的一个特征性亚组。然而，在本研究中，我们首次报告了一例具有激素受体表达的LGASC病例。
对一名42岁女性患者获取的乳腺肿瘤标本进行了病理分析。形态学上，它由具有散在鳞状分化的腺管结构组成，伴有梭形细胞间质的杂乱排列。免疫组化显示，所有肌上皮和鳞状分化标志物均呈现典型的LGASC阳性或阴性染色模式。有趣的是，我们发现该病例中通常异常的激素受体被重新激活。据我们所知，这是首例激素受体阳性的LGASC报告。除此之外，在扩大切除样本中，我们发现了散在的鳞状化生和 florid 腺鳞增生（ASP）。同时，它对CD44变异异构体（CD44v）呈阳性，CD44v是一种乳腺癌干细胞（CSC）标志物，在LGASC、鳞状化生和ASP中均有表达。
具有激素受体表达的LGASC。
进行了乳腺扩大局部切除和腋窝淋巴结清扫。
手术切除6个月后，患者无局部复发和远处转移。
我们在此报告了首例对激素受体具有免疫反应性的LGASC病例，扩展了其免疫表型谱。CD44v可能在LGASC前体病变向恶性过程的转变中起重要作用，这可能成为LGASC的一个治疗靶点。
