Ichihara S, Aoyama H
Department of Pathology, Nagoya National Hospital, Japan.
Pathol Int. 1994 Sep;44(9):722-6. doi: 10.1111/j.1440-1827.1994.tb02953.x.
An unusual case of intraductal carcinoma of the breast arising in sclerosing adenosis is reported. A 49 year old Japanese woman noticed a lump in her right breast 3 years before she sought medical advice. Histologic examination of the lumpectomy specimen showed, adjacent to intraductal papilloma, sclerosing adenosis involved in a neoplastic cellular proliferation with cribriform pattern and comedo necrosis. Immunohistochemical study with anti-actin antibodies discriminated intraductal carcinoma from adjacent sclerosing adenosis by highlighting myoepithelial components in the latter. Extensive sampling revealed no carcinoma outside the sclerosing adenosis, implying that the intraductal carcinoma did originate in the tubules of sclerosing adenosis. A review of the literature indicated that the ductal to lobular ratio among carcinoma in situ concurring with sclerosing adenosis is about 1:2. The average age of patients with ductal and lobular carcinoma in situ in sclerosing adenosis is 39 and 43.7, respectively. It is suggested that carcinoma in situ arising in sclerosing adenosis and fibroadenoma have a similar biological basis.
报告了一例罕见的硬化性腺病中发生的乳腺导管内癌。一名49岁的日本女性在寻求医疗建议前3年发现右乳有一个肿块。肿块切除标本的组织学检查显示，在导管内乳头状瘤附近，硬化性腺病伴有呈筛状结构和粉刺样坏死的肿瘤性细胞增殖。用抗肌动蛋白抗体进行的免疫组织化学研究通过突出后者的肌上皮成分，将导管内癌与相邻的硬化性腺病区分开来。广泛取材显示硬化性腺病外无癌，这意味着导管内癌确实起源于硬化性腺病的小管。文献回顾表明，与硬化性腺病同时存在的原位癌中，导管癌与小叶癌的比例约为1:2。硬化性腺病中原位导管癌和原位小叶癌患者的平均年龄分别为39岁和43.7岁。提示硬化性腺病和纤维腺瘤中发生的原位癌具有相似的生物学基础。
