Luna-Moré S, Gonzalez B, Acedo C, Rodrigo I, Luna C
Department of Pathology, Hospital Regional Carlos Haya, Málaga, Spain.
Pathol Res Pract. 1994 Aug;190(7):668-74. doi: 10.1016/S0344-0338(11)80745-4.
After reviewing 986 consecutive cases of breast carcinoma from our files, 27 ductal infiltrating cancers showing micropapillary differentiation in invasive areas (MP) were selected. Special immunohistological and ultrastructural techniques were used, and their characteristics compared to those of the Not Otherwise Specified type of carcinomas (NOS). Diagnostic areas of MP were easily identified in H&E sections and were composed of solid or tubular neoplastic cell groups inside a spongy background, where they appeared to swim in aqueous or mucinous material. Neoplastic cells displayed the reverse polarity typical of the papillary phenotype. This was revealed by the detection of acid mucinous rims, lineal deposits of EMA substances, and microvilli in a peripheral position, even in areas where the micropapillae resembled tubules. Histologically, most MP were mixed with N0S, Papillary, or Mucinous patterns, but regardless of the extension of their micropapillary diagnostic component, their tumour size, or their WHO histological grade, two thirds had extensive lymphatic vessel invasion and all the cases presented massive axillary lymph node metastasis. Six of the twelve patients followed died within a mean of 22 months. In conclusion, we propose the recognition of "Invasive Micropapillary Carcinoma of the Breast" as a new special entity with a potentially high degree of aggressiveness.
在查阅了我们档案中连续的986例乳腺癌病例后，选取了27例在浸润区域显示微乳头分化的导管浸润癌（MP）。采用了特殊的免疫组织化学和超微结构技术，并将其特征与未另行指定类型的癌（NOS）进行了比较。MP的诊断区域在苏木精-伊红（H&E）切片中很容易识别，由海绵状背景内的实性或管状肿瘤细胞群组成，在其中它们似乎在水性或粘液性物质中游动。肿瘤细胞表现出乳头表型典型的反向极性。这通过检测酸性粘液边缘、EMA物质的线性沉积以及周边位置的微绒毛得以揭示，即使在微乳头类似小管的区域也是如此。组织学上，大多数MP与NOS、乳头状或粘液性模式混合，但无论其微乳头诊断成分的范围、肿瘤大小或世界卫生组织（WHO）组织学分级如何，三分之二的病例有广泛的淋巴管侵犯，所有病例均有大量腋窝淋巴结转移。随访的12例患者中有6例在平均22个月内死亡。总之，我们建议将“乳腺浸润性微乳头癌”识别为一种具有潜在高度侵袭性的新的特殊实体。
