Schmitt F C, Soares R, Seruca R
Institute of Molecular Pathology and Immunology of Porto University, IPATIMUP, Portugal.
Virchows Arch. 1998 Dec;433(6):505-9. doi: 10.1007/s004280050281.
Apocrine carcinoma is an uncommon variant of breast cancer. The frequency of bilaterality in patients who have apocrine carcinoma in one breast is not significantly different from that for bilateral mammary carcinomas in general, but bilateral apocrine carcinomas are very uncommon. We report on a bilateral apocrine carcinoma of the breast in a 74-year-old woman. The apocrine differentiation in both tumours was confirmed by the positivity of the cytoplasmic granules for PAS after diastase digestion and immunoreactivity for GCDFP-15 and sialyl-Tn. The tumour in the right breast showed immunohistochemical expression of p53, and a mutation was demonstrated by PCR-SSCP; the tumour in the left breast was negative for p53 on immunohistochemistry, and no mutation was found at the molecular level. c-erbB2 expression was not detected in the right tumour but there was overexpression (at the cell membrane) in the left tumour. Both tumours were aneuploid: the right tumour displayed multiple stemlines, whereas the left tumour had a triploid profile. Using the fluorescence in situ hybridization technique we demonstrated that both tumours displayed chromosome 17 polysomy and numerical abnormalities of chromosome 1, polysomy in the right and monosomy in the left tumour. We conclude that the two tumours are probably independent, as are most bilateral carcinomas of the breast.
大汗腺癌是一种罕见的乳腺癌变异类型。一侧乳房患有大汗腺癌的患者中双侧发病的频率与一般双侧乳腺癌患者相比无显著差异，但双侧大汗腺癌非常少见。我们报告一例74岁女性双侧乳腺大汗腺癌。经淀粉酶消化后胞质颗粒对PAS呈阳性反应以及对GCDFP - 15和唾液酸化Tn具有免疫反应性，证实了两个肿瘤均有大汗腺分化。右侧乳房的肿瘤显示p53的免疫组化表达，通过PCR - SSCP证实存在突变；左侧乳房的肿瘤免疫组化p53为阴性，分子水平未发现突变。右侧肿瘤未检测到c - erbB2表达，而左侧肿瘤存在过表达（在细胞膜）。两个肿瘤均为非整倍体：右侧肿瘤显示多个干系，而左侧肿瘤为三倍体核型。使用荧光原位杂交技术我们证实两个肿瘤均显示17号染色体多体性以及1号染色体的数目异常，右侧肿瘤为多体，左侧肿瘤为单体。我们得出结论，这两个肿瘤可能像大多数双侧乳腺癌一样是独立的。
