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目的:探讨原发性乳腺骨肉瘤的临床病理学特征、诊断及治疗。方法:报告1例原发性乳腺骨肉瘤,并结合文献复习。结果:患者临床症状和辅助检查无特异性,病理检查示肿瘤由梭形细胞组成,伴有不同比例的骨样或骨组织,部分有软骨分化;免疫组化标记梭形肿瘤细胞vimentin强阳性,Ki-67增值指数约15%,破骨样巨细胞vimentin和CD68阳性,软骨肉瘤细胞S-100阳性;CK无表达。结论:原发性乳腺骨肉瘤极罕见,预后较差,术前诊断困难,确诊依靠病理学检查和免疫组化;治疗以手术为主,术后化疗或放疗效果不明确。
Objective: To investigate the clinicopathological features, diagnosis and treatment of primary breast osteosarcoma. Methods: One case of primary osteosarcoma was reported and reviewed. Results: The patients had no specific clinical symptoms and auxiliary examinations. The pathological examination showed that the tumors consisted of spindle cells with different proportions of osteoid or bone tissue, and some of them had cartilage differentiation. The immunohistochemical staining of vimentin was strongly positive in spindle cells, Ki-67 value-added index of about 15%, osteoclast-like giant cells vimentin and CD68 positive, chondrosarcoma S-100 positive cells; CK no expression. Conclusion: Primary breast osteosarcoma is extremely rare with poor prognosis. It is difficult to diagnose before operation. The diagnosis depends on pathological examination and immunohistochemistry. The treatment is mainly based on surgery. The effect of postoperative chemotherapy or radiotherapy is not clear.