Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Anticancer Res. 2020 May;40(5):2933-2939. doi: 10.21873/anticanres.14271.
BACKGROUND/AIM: Peritoneal fluid (PF) cytology is critical for distinguishing high-grade serous carcinoma (HGSC) from metastatic disease in patients with breast carcinoma who present with peritoneal carcinomatosis (PC).
A 50-year-old woman underwent surgery and adjuvant therapy for pT1N0 grade 2/2 luminal A breast carcinoma. Sixteen months postoperatively, palliative chemotherapy was administered following a pleural biopsy and diagnosis of metastatic carcinoma. The patient developed PC despite chemotherapy. PF cytology specimens suggested metastatic carcinoma. However, we observed a papillary cellular arrangement during the review of cytology slides. HGSC was confirmed by immunocytochemistry showing positive paired box 8 (PAX8) and Wilms' tumor 1 (WT1) expression and negative GATA-binding protein 3 expression.
In patients with breast carcinoma history, an awareness of characteristic cytomorphology of HGSC, including a papillary pattern with positive PAX8 and WT1 immunoreactivity, is essential to prevent the misdiagnosis of such cases and in ensuring accurate treatment and management.
背景/目的：对于患有乳腺癌并出现腹膜癌病（PC）的患者，腹膜液（PF）细胞学检查对于将高级别浆液性癌（HGSC）与转移性疾病区分开来至关重要。
一名 50 岁女性因 T1N0 级 2/2 腔A型乳腺癌接受了手术和辅助治疗。术后 16 个月，在胸膜活检和转移性癌诊断后进行了姑息性化疗。尽管进行了化疗，该患者仍出现了 PC。PF 细胞学标本提示转移性癌。然而，在细胞学幻灯片复查过程中，我们观察到乳头状细胞排列。免疫细胞化学显示阳性配对盒 8（PAX8）和维尔姆斯瘤 1（WT1）表达以及阴性 GATA 结合蛋白 3 表达，证实为 HGSC。
对于有乳腺癌病史的患者，认识到包括具有 PAX8 和 WT1 免疫反应性的乳头状模式在内的 HGSC 的特征性细胞学形态对于防止此类病例的误诊以及确保准确的治疗和管理至关重要。
