Das D K, Samhan M, Bashir H M, Sheikh Z A, al-Mousawi M, Behbehani A, Junaid T A
Cytopathology Unit, Mubarak Al-Kabeer Hospital, Kuwait.
Acta Cytol. 1994 Nov-Dec;38(6):917-22.
A 46-year-old woman presented with a mass in the left breast and left axillary lymphadenopathy. Five years earlier she had received a renal transplant from an unrelated donor because of end-stage renal failure secondary to adult polycystic kidney disease. She was on immunosuppression therapy in the form of cyclosporine, azathioprine and prednisolone. Fine needle aspiration cytology of the breast mass showed a metaplastic (sarcomatoid) carcinoma, whereas the axillary lymph node aspirate suggested carcinosarcoma. Immunocytochemical studies revealed dense positivity for vimentin in the sarcomatous component and positivity for epithelial membrane antigen in the epithelial component. Rare cells were positive for cytokeratin. The cytodiagnosis was confirmed by excision biopsy of axillary lymph nodes. The patient died on the fourth postoperative day following left mastectomy and axillary clearance. The histopathology report of the breast tumor showed sarcomatoid carcinoma.
一名46岁女性因左乳肿块及左腋窝淋巴结肿大就诊。5年前，她因成人多囊肾继发终末期肾衰竭，接受了来自非亲属供体的肾移植。她正在接受环孢素、硫唑嘌呤和泼尼松龙形式的免疫抑制治疗。乳房肿块的细针穿刺细胞学检查显示为化生性（肉瘤样）癌，而腋窝淋巴结穿刺提示为癌肉瘤。免疫细胞化学研究显示，肉瘤成分中波形蛋白呈强阳性，上皮成分中上皮膜抗原呈阳性。罕见细胞细胞角蛋白呈阳性。腋窝淋巴结切除活检证实了细胞诊断。患者在左乳房切除和腋窝清扫术后第四天死亡。乳腺肿瘤的组织病理学报告显示为肉瘤样癌。
