Yokoo H, Nakazato Y
First Department of Pathology, Gunma University School of Medicine, Maebashi, Japan.
Pathol Int. 1998 Jul;48(7):545-8. doi: 10.1111/j.1440-1827.1998.tb03947.x.
A case of primary localized amyloid tumor of the breast is described. It is an extremely rare condition and has not been seen in literature in Japan. A 76-year-old woman visited a hospital because of a painless, hard mass of the right breast. A relatively well demarcated, calcified mass was excised under clinical diagnosis of fibroadenoma. Histologically, massive eosinophilic amorphous material was deposited in breast stroma. It was stained red-orange by Congo red and displayed apple-green birefringence under polarized light. The staining persisted after incubation with KMnO4 and immunolabeling by immunoglobulin chi-light chain antiserum, consistent with the amyloid of AL (Achi) type. Osseous metaplasia with bone marrow cavity, foreign body type giant cells in response to amyloid, and scattered plasma cell infiltration were also recognized. Osseous metaplasia in the breast amyloid tumor has been reported in only one case before. To date, the patient has not developed any clinical or laboratory evidence of systemic amyloidosis or multiple myeloma.
本文报道了一例原发性局限性乳腺淀粉样瘤病例。这是一种极为罕见的疾病，在日本文献中未见报道。一名76岁女性因右侧乳房无痛性硬块就诊。在临床诊断为纤维腺瘤的情况下，切除了一个边界相对清晰的钙化肿块。组织学检查显示，大量嗜酸性无定形物质沉积于乳腺间质。刚果红染色呈红橙色，偏振光下显示苹果绿双折射。经高锰酸钾孵育及免疫球蛋白κ轻链抗血清免疫标记后，染色持续存在，符合AL（Aκ）型淀粉样变。还可见伴有骨髓腔的骨化生、对淀粉样变产生反应的异物型巨细胞以及散在的浆细胞浸润。乳腺淀粉样瘤中的骨化生此前仅在一例中报道过。迄今为止，该患者未出现任何系统性淀粉样变或多发性骨髓瘤的临床或实验室证据。
