Wang Xiao, Li Yujun, Zhao Peng, Jia Huiqing, Dong Xianning, Zhang Longxiao, Wang Chengqin
Department of Pathology, The Affiliated Hospital of Qingdao University Qingdao, China.
Department of Pathology, School of Basic Medicine, Qingdao University Qingdao, China.
Int J Clin Exp Pathol. 2020 Oct 1;13(10):2562-2568. eCollection 2020.
To explore the clinicopathologic features and differential diagnosis of breast primary mucinous cystadenocarcinoma (MCA).
Pathological characteristics and immunophenotype of one case of MCA were analyzed. Literature was reviewed.
Grossly, the area of the tumor cut surface was gelationous. Microscopcally, the tumor was composed of variably sized cystic spaces lined by mucus-rich tumor cells with single columnar, stratified appearance and papillary formation. The degree of cytologic atypia varied from region to region. The tumor cells were positive for CK7, GATA3, negative for CK20, ER, PR and HER2. Most peripheral myoepithelial cells were negative for P63 and SMMHC.
MCA is a rare primary breast cancer and strikingly similar to ovarian, pancreatic and gastrointestinal counterparts. The diagnosis cannot be made until the metastatic lesion is ruled out. On the other hand, the biologic behavior of MCA is reportedly favorable despite a high proliferation index and triple negative biomarker status. Therefore, the role of adjuvant chemotherapy or radiation is questionable.
探讨乳腺原发性黏液性囊腺癌（MCA）的临床病理特征及鉴别诊断。
分析1例MCA的病理特征及免疫表型，并复习相关文献。
大体上，肿瘤切面呈胶冻状。镜下，肿瘤由大小不等的囊腔构成，内衬富含黏液的肿瘤细胞，呈单层柱状、复层状外观及乳头形成。不同区域的细胞异型程度不同。肿瘤细胞CK7、GATA3阳性，CK20、ER、PR及HER2阴性。大多数外周肌上皮细胞P63和SMMHC阴性。
MCA是一种罕见的原发性乳腺癌，与卵巢、胰腺和胃肠道的同类肿瘤极为相似。在排除转移瘤之前无法做出诊断。另一方面，尽管MCA增殖指数高且具有三阴性生物标志物状态，但据报道其生物学行为良好。因此，辅助化疗或放疗的作用值得怀疑。
