Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland
Department of Histopathology, St Vincent's University Hospital, Dublin, Ireland.
J Clin Pathol. 2019 Jan;72(1):1-6. doi: 10.1136/jclinpath-2018-205484. Epub 2018 Nov 8.
Apocrine morphology is a common phenomenon encountered in everyday breast pathology practice, and is defined as cuboidal or columnar cells exhibiting abundant eosinophilic granular cytoplasm, prominent apical granules, a low nuclear-cytoplasmic ratio, and round nuclei with pale chromatin and prominent nucleoli. Apocrine morphology is recognised in benign, atypical and malignant lesions of the breast. The morphology of apocrine atypia and non-high-grade apocrine ductal carcinoma in situ (DCIS) is less well defined due to the relative rarity of these lesions. In part 1 of this two-part review, we focus on the morphological characteristics of benign, atypical and in situ apocrine lesions of the breast, summarise the available data to date regarding distinction of atypical apocrine proliferations from non-high-grade apocrine DCIS and the biological significance of apocrine atypia, and provide practical guidance on handling these difficult lesions. Part 2 of this review will focus on the concept of pure apocrine carcinoma with emphasis on its definition and molecular data, including the current understanding of the molecular apocrine signature in breast carcinoma. We complete the review with a synopsis on the utility of immunohistochemistry in the diagnosis of apocrine lesions of the breast.
顶泌腺形态是日常乳腺病理学实践中常见的现象，其定义为具有丰富嗜酸性颗粒细胞质、突出的顶端颗粒、低核浆比以及圆形细胞核、淡染染色质和明显核仁的立方或柱状细胞。顶泌腺形态可见于乳腺的良性、非典型和恶性病变。由于这些病变相对罕见，因此顶泌腺非典型性和非高级别顶泌腺导管原位癌（DCIS）的形态学特征定义不明确。在这篇两部分综述的第 1 部分中，我们重点关注乳腺的良性、非典型和原位顶泌腺病变的形态特征，总结迄今为止关于非典型顶泌腺增生与非高级别顶泌腺 DCIS 区分的可用数据，以及顶泌腺非典型性的生物学意义，并就处理这些困难病变提供实用指导。这篇综述的第 2 部分将重点介绍纯顶泌腺癌的概念，强调其定义和分子数据，包括目前对乳腺癌中分子顶泌腺特征的理解。我们将通过对乳腺顶泌腺病变中免疫组织化学的应用综述来完成这篇综述。
