Ashton M A, Lefkowitz M, Tavassoli F A
Department of Gynecologic and Breast Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.
Mod Pathol. 1994 Jan;7(1):49-54.
Fourteen examples of lymphocytic mastitis (LM) with epithelioid stromal cells characterized by formation of a palpable, hard breast mass composed of a predominantly lobulocentric lymphocytic infiltrate, stromal fibrosis, and an unusual stromal infiltrate of epithelioid cells are presented. The epithelioid cells were so prominent and abundant that the possibility of an infiltrating carcinoma was raised in three cases, and a fourth case was misinterpreted as a granular cell tumor. Interestingly, eight of the 12 women and the only male patient had long standing, insulin dependent diabetes mellitus (IDDM), whereas two had IDDM and hypothyroidism, one had hypothyroidism alone, and one had systemic lupus erythematosus. Contrary to the conclusions in a recent report, our findings indicate that these mammary changes are not exclusive to patients with IDDM, and may also occur in nondiabetic patients particularly those with autoimmune disorders. The morphologic features of the epithelioid stromal cells which have been mistaken for infiltrating carcinoma are emphasized; immunohistochemical and ultrastructural findings favoring their myofibroblastic nature are presented.
本文报告了14例伴有上皮样间质细胞的淋巴细胞性乳腺炎（LM），其特征为形成可触及的坚硬乳腺肿块，主要由小叶中心性淋巴细胞浸润、间质纤维化以及不寻常的上皮样细胞间质浸润组成。上皮样细胞非常显著且丰富，在3例病例中引发了浸润性癌的可能性，第4例被误诊为颗粒细胞瘤。有趣的是，12名女性中的8名以及唯一的男性患者患有长期胰岛素依赖型糖尿病（IDDM），而另外2名患有IDDM和甲状腺功能减退症，1名仅患有甲状腺功能减退症，1名患有系统性红斑狼疮。与最近一份报告的结论相反，我们的研究结果表明，这些乳腺变化并非IDDM患者所特有，也可能发生在非糖尿病患者中，尤其是那些患有自身免疫性疾病的患者。文中强调了曾被误诊为浸润性癌的上皮样间质细胞的形态学特征；展示了支持其肌成纤维细胞性质的免疫组化和超微结构研究结果。
