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摘要:
目的 探讨乳腺纤维瘤病的临床病理特征及鉴别诊断要点。 方法 回顾性分析5例乳腺纤维瘤病患者的临床资料并进行组织形态学、免疫组织化学研究, 对其临床表现、病理形态特点及鉴别诊断进行总结。 结果 5例均为女性, 发病年龄24~75岁, 平均年龄53岁。3例行乳腺病灶活检术, 2例行乳腺单纯切除术。乳腺纤维瘤病由梭形细胞(纤维母细胞/肌纤维母细胞)构成, 背景是丰富的胶原纤维, 有程度不等的玻璃样变性。细胞数量不等, 没有或仅有轻度的细胞不典型性和多形性, 核分裂象少见。免疫组织化学染色5例vimentin均阳性, SMA均部分阳性, 3例β-catenin阳性, 而cytokeratin、desmin、EMA、S-100和CD68均阴性。 结论 乳腺纤维瘤病是一种罕见乳腺肿瘤, 呈进行性、侵袭性生长。 Abstract:Objective To investigate the clinicopathological features and differential diagnosis of fibromatosis of the breast. Methods Five cases of breast fibromatosis were reviewed based on clinical, histomorphological, and immunohistochemical studies. Their clinical manifestations, pathologic features and main points of differential diagnosis were discussed. Results The 5 cases were all females, with age of onset ranging from 24 to 75 years and an average age of 53 years. Three cases underwent breast focal biopsy, and 2 cases underwent simple mastectomy. Breast fibromatosis was composed of spindle cells (fibroblasts/myofibroblasts) in a background of numerous thick and wavy collagen fibers, showing various degrees of hyaline degeneration. The cells varied in number, but all with absence or low degree of pleomorphism and hypercellularity, and scarcity of mitotic figures. According to immunohistochemical study, the 5 cases were all vimentin positive and SMA partly positive, 3 cases were β-catenin positive, while cytokeratin, desmin, EMA, S-100 and CD68 were negative. Conclusion Fibromatosis of the breast is a rare breast tumor, developing in a progressive and invasive pattern. -
Key words:
- breast /
- fibromatosis /
- clinicopathology
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表 1 5例乳腺纤维瘤病患者临床资料
病例 性别 年龄(岁) 病史 病变部位 超声诊断 术中所见 大小 1 女 56 自行发现右乳肿物1月余 右乳外下象限 低回声,形态规则,内见多个条索状中高回声 乳腺及胸大肌中可见4 cm×2 cm×2 cm肿块 4 cm×2 cm×2 cm 2 女 24 自行触及右乳肿物半年余 右乳外上象限 低回声,形态不规则,边界不清,内部回声不均 乳腺腺体组织中触及直径约1.7 cm光滑结节 直径1.7 cm 3 女 75 无意中发现左乳结节2周 左乳内上象限 无 乳腺组织可及直径1 cm质硬结节,与胸大肌有粘连,活动可 直径1 cm 4 女 66 胸前区瘢痕持续增大30余年,伴局部溢液2年,既往脑膜瘤手术史 双侧乳腺 无 瘢痕及双侧乳腺单纯切除 直径3 cm 5 女 44 发现左乳肿物4个月,既往有2次乳腺错构瘤手术史 左乳乳晕下 无 乳腺单纯切除 直径4 cm -
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