乳腺上皮-肌上皮性肿瘤4例临床病理学分析

摘要

Objective: To determine the clinicopathologic features, immunohistochemistry, diagnosis and differential diagnosis of epithelial-myoepithelial tumor of breast.Methods: Clinical characteristics, pathological morphology and immunohistochemical staining in 4 cases of mammary epithelial-myoepithelial tumors were analyzed, and literature was reviewed.Results: The patients included 3 females and 1 male. The age of patients ranged from 27 to 63 years old (median=51 years). The size of the 4 tumors ranged from 1.5 to 3.0 cm in diameter (median=2.0 cm). Gross examination showed that the 4 tumors were gray-white and without true ifbrous capsule. Microscopically, the feature of the tumor was double-layer tubular pattern, which composed of glandular epithelial and myoepithelial cells. hTe glandular epithelial cells were located in the inner layer of the tubular pattern, while the myoepithelial cells were located in the outer layer. Immunohistochemical results showed that the expression of CK8/18 and CK7 in glandular epithelial cells was positive, while the expression of p63, Calponin, CK5/6 in myoepithelial cells was positive. One case was diagnosed as adenomyoepithelioma, and 3 cases were diagnosed as malignant adenomyoepithelioma.Conclusion:Epithelial-myoepithelial tumor of breast is a rare neoplasm, which should be distinguished from intraductal papilloma, metaplastic carcinoma, and others.%目的：探讨乳腺上皮-肌上皮性肿瘤(epithelial-myoepithelial tumor of breast)的临床病理学特点、免疫表型、诊断及鉴别诊断。方法：对4例乳腺上皮-肌上皮性肿瘤的临床特点、组织形态学及免疫组织化学结果进行分析，并复习相关文献。结果：患者：男性1例，女性3例，平均年龄51岁(27~63岁)。4例肿瘤直径1.5~3.0 cm(平均2.0 cm)，无包膜，切面灰白色。显微镜下可见肿瘤由双相增生的肌上皮细胞和腺上皮细胞构成，肌上皮细胞环绕腺上皮细胞构成特征的套管结构。免疫组织化学染色，腺上皮细胞表达CK8/18、CK7，肌上皮细胞表达p63、Calponin、CK5/6。1例诊断为腺肌上皮瘤(adenomyoepithelioma，AME)，3例诊断为伴有癌的腺肌上皮瘤(恶性腺肌上皮瘤， malignant adenomyoepithelioma，MAME)。结论：乳腺上皮–肌上皮性肿瘤是少见的肿瘤类型，需与导管内乳头状瘤、化生性癌等鉴别。