Damron Alexander T, Korhonen Katrina, Zuckerman Samantha, Tchou Julia, Dumoff Kimberly L, Bleiweiss Ira J, Nayak Anupma
1 Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Int J Surg Pathol. 2019 Oct;27(7):781-787. doi: 10.1177/1066896919845493. Epub 2019 May 2.
Microglandular adenosis (MGA) of the breast is exceedingly rare, with only a few case reports and series published to date. Previous studies have elegantly demonstrated the progression of benign MGA to atypical MGA to MGA-in situ carcinoma to invasive carcinoma and therefore suggest MGA as a possible non-obligate precursor lesion to a subset of breast carcinomas. Immunohistochemically, MGA is negative for estrogen receptor (ER), progesterone receptor (PR), and HER2-neu oncoprotein expression, and carcinomas arising in the setting of MGA are often reported to be triple negative. In this article, we present a unique case of an ER+/PR+/HER2- invasive carcinoma associated with MGA and atypical MGA. Our case highlights the diagnostic pitfall of MGA and suggests that MGA is a heterogeneous group of lesions with potential for either luminal-type or basal-type differentiation during progression to breast carcinoma.
乳腺微腺性腺病(MGA)极为罕见,迄今为止仅有少数病例报告和系列研究发表。既往研究已确切表明,良性MGA可进展为非典型MGA、原位癌及浸润性癌,因此提示MGA可能是一部分乳腺癌的非必然前驱病变。免疫组化显示,MGA的雌激素受体(ER)、孕激素受体(PR)及HER2-神经癌蛋白表达均为阴性,且常报道MGA背景下发生的癌为三阴性。在本文中,我们报告了1例与MGA及非典型MGA相关的ER+/PR+/HER2-浸润性癌的独特病例。我们的病例突出了MGA的诊断陷阱,并提示MGA是一组异质性病变,在进展为乳腺癌的过程中具有向管腔型或基底型分化的潜力。