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目的讨论3例乳腺导管小叶混合型癌的病理诊断,提高对该病的认识。方法采用常规HE染色及免疫组化SP染色获得正确诊断。结果乳腺导管小叶混合型癌具有两种不同类型的肿瘤形态,其中非特殊性浸润性导管癌区占肿瘤体积<49%,细胞具有多形性,排列呈实性癌巢、管状、条索状结构;浸润性小叶癌区细胞较小而一致,呈靶环状、列兵式排列特点,二者移行混合存在。免疫组化:ER、PR和c-erbB-2(2+),CK5(-),CK8(+);导管癌区E-cadherin(+),细胞膜p120(+);小叶癌区E-cadherin(-),34βE12(+),细胞质p120(+);Ki-67阳性指数>30%。结论乳腺导管小叶混合型癌是一种少见的乳腺异质性癌,以乳腺非特殊性浸润性导管癌和小叶癌混合存在为特征,易误诊为单纯的乳腺非特殊性浸润性导管癌或小叶癌,生物学行为更接近乳腺非特殊性导管癌。
Objective To discuss the pathological diagnosis of 3 cases of ductal lobular mixed carcinoma and to improve the understanding of the disease. Methods The routine HE staining and immunohistochemical SP staining obtained the correct diagnosis. Results Breast ductal lobular mixed carcinoma had two different types of tumor morphology, of which non-specific invasive ductal carcinoma accounted for <49% of the tumor volume, the cells were pleomorphic, arranged in solid cancer nests, tubular, cord-like Structure; infiltrating small lobe of cancer cells smaller and consistent, was the target ring, Trojans arranged features, the two mixed existence of migration. E-cadherin (+) and cell membrane p120 (+) were detected by immunohistochemistry: ER, PR and c-erbB-2, CK5 and CK8; (-), 34βE12 (+), cytoplasm p120 (+); Ki-67 positive index> 30%. Conclusions Breast ductal lobular mixed carcinoma is a rare breast heterogeneous carcinoma characterized by the mixed existence of nonspecific invasive ductal carcinoma and lobular carcinoma of the breast and is easily misdiagnosed as a simple non-specific invasive ductal carcinoma or leaflet of the breast Cancer, biological behavior closer to breast non-specific ductal carcinoma.