Singh Guddi Rani, Kumari Mamta, Sunny Kumari, Haldar Debaditya, Kumar Manish, Prasad Rajnikant
Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Department of Surgical Oncology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Niger Med J. 2022 May 23;65(2):222-230. doi: 10.60787/nmj-v65i2-312. eCollection 2024 Mar-Apr.
Knowledge regarding the lesser common breast tumours, including malignant papillary neoplasms and glycogen-rich clear cell carcinoma, is limited. Overall, cases of papillary carcinoma of the breast fare better than invasive breast carcinoma, from the data available in literature. Glycogen-rich clear cell carcinoma is characterized by the presence of clear cells, having mostly a poorer prognosis. We hereby present three such cases which would add to the existing available information. is a 79-year-old female who presented with a left breast lump and bloody nipple discharge. Mammography suggested malignant lesion, with FNAC suspicious of malignancy. Surgery was done and histopathological examination showed irregular islands of tumour cells having papillary fronds with absence of myoepithelial layer. Immunohistochemically, the tumour was GATA3, CK7, ER, PR positive, HER2 negative, with Ki67 index 10%. The case was diagnosed as Solid papillary carcinoma. is a 57-year-old female presenting with a left breast lump along with bloody nipple discharge. Mammography and FNAC were in favour of malignancy. Trucut biopsy was done, microscopy revealing a tumour having >90% papillary architecture with infiltrative pattern. Features were suggestive of Invasive breast carcinoma with papillaroid features. The tumour was GATA3, CK7, ER, PR positive, HER2 negative, with Ki67 index 15%. is a 70-year-old female presenting with a right breast lump with nipple retraction. Mammography and FNAC were suggestive of malignancy. Trucut biopsy followed by microscopy revealed polygonal tumour cells with clear cytoplasm in nested pattern, showing positive staining for Periodic Acid Schiff. Immunostaining showed GATA3 positive, PAX8 negative, ER and PR positive, HER2 negative, and Ki67 index 20%. A diagnosis of Invasive breast carcinoma with Glycogen-rich clear cell pattern was made. Identifying these rare entities is important along with assessing hormone status for avoiding overtreatment and undertreatment and applying appropriate targeted therapies.
关于少见的乳腺肿瘤，包括恶性乳头状肿瘤和富含糖原的透明细胞癌的知识有限。总体而言，从文献中的现有数据来看，乳腺乳头状癌的病例比浸润性乳腺癌的预后更好。富含糖原的透明细胞癌的特征是存在透明细胞，其预后大多较差。我们在此呈现三例这样的病例，这将补充现有的可用信息。病例一是一名79岁女性，表现为左乳肿块和乳头血性溢液。乳腺钼靶检查提示恶性病变，细针穿刺活检（FNAC）怀疑为恶性。进行了手术，组织病理学检查显示肿瘤细胞呈不规则岛状，有乳头状叶，无肌上皮层。免疫组化显示，肿瘤GATA3、CK7、雌激素受体（ER）、孕激素受体（PR）阳性，人表皮生长因子受体2（HER2）阴性，Ki67指数为10%。该病例被诊断为实性乳头状癌。病例二是一名57岁女性，表现为左乳肿块及乳头血性溢液。乳腺钼靶检查和FNAC均支持恶性诊断。进行了粗针活检，显微镜检查显示肿瘤具有>90%的乳头状结构及浸润性模式。特征提示为具有乳头状特征的浸润性乳腺癌。肿瘤GATA3、CK7、ER、PR阳性，HER2阴性，Ki67指数为15%。病例三是一名70岁女性，表现为右乳肿块伴乳头回缩。乳腺钼靶检查和FNAC提示为恶性。随后进行粗针活检及显微镜检查，显示多边形肿瘤细胞，胞质透明，呈巢状排列，高碘酸希夫染色呈阳性。免疫染色显示GATA3阳性，配对盒基因8（PAX8）阴性，ER和PR阳性，HER2阴性，Ki67指数为20%。诊断为具有富含糖原透明细胞模式的浸润性乳腺癌。识别这些罕见实体并评估激素状态对于避免过度治疗和治疗不足以及应用适当的靶向治疗很重要。
