目的:探讨乳腺富脂质癌(Lipid-rich carcinoma of the breast)的病理和临床特点.方法:回顾性分析1例乳腺富脂质癌的病理、临床资料,结合文献复习并讨论.结果:乳腺富脂质癌病理特征是肿瘤细胞聚集呈实体性,团索状,部分导管扩张内充满泡沫样瘤细胞,癌细胞较大,胞浆透明或泡沫状,充满中等到大量中性脂质,脂肪染色呈强阳性.免疫组化标记:油红O染色(+)、ER(-)、PR(-)、C-erb-2(+),过碘酸雪夫氏(PAS)染色(-).治疗上予手术、化疗、放疗等综合治疗,随访2年4个月,患者出现远处转移死亡.结论:乳腺富脂质癌是一种罕见特殊类型乳腺癌,该病恶性度高,进展快,预后差,临床表现缺乏特异性.熟悉其病理特点,准确做出病理诊断,避免误诊显得尤为重要.临床应在明确诊断后进行以手术为主的综合治疗.%Objective :To evaluate the pathologic and clinical features about the lipid - rich carcinoma of breast. Methods : To retrospectively analyze the pathologic and clinical data on 1 case of lipid - rich carcinoma of breast as well as review the literatures. Results: The pathological features of the lipid - rich carcinoma of the breast is that tumor cells mass like solid and cords, foamy tumor cells fill in the mammary duct, cancer cells are comparatively large, cytoplasm show transparent or foamy and fill with middle to large number of neutral lipids, fat staining was strongly positive. Immunohistochemistry: oil red O staining ( ＋ ). ER ( － ), PR ( － ), C - erb -2 ( ＋ ), periodic acid Schiff ( PAS ) staining ( － ). Patients received comprehensive therapy such as surgery, chemotherapy and radiotherapy and so on, followed for 2 years and 4 months, and died of distant metastases. Conclusion: The lipid - rich carcinoma of breast is a rare special type of hreast cancer. with high - grade malignancy, rapid development, poor prognosis and lack of specific clinical manifestations, it is very important to familiar with its pathologic: features, make accurate pathological diagnosis and avoid misdiagnosis. Multimodality treatment including surgery should be immediately carried out after diagnosis.
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