乳腺纤维瘤病临床病理分析

摘要

Objective To investigate the clinicopathological features,diagnosis and differential diagnosis of fibromatosis of the breast. Methods The clinical manifestations,pathological features and immunohistochemical features of 36 cases of breast cancer were analyzed retrospectively. Results The 36 cases were all females,with age of onset ranging from 16 to 75 years and an average of 35. Histopathologically, breast fibromatosis was composed of spindle fibrorblasts and myofibroblasts in a background of collagen fibers,showing various degrees of hyaline degeneration. The tumor cells arranged in long and intersecting fasciles,with no obvious pleomorphism and scarcity of mitotic figures. The edge was infiltrative and may invade around normal structures. Immunohistochemically,most cases were positive for Vimentin and SMA,partly positive forβ-catenin,whereas CKpan、Desmin、S-100、ER、PR and CD34 were negative,Ki-67 positive index was under 5%. Conclusion Fibromatosis of the breast is a rare breast tumor,developing in a progressive and invasive pattern. The final diagnosis depends on histopathologic manifestations and it should be distinguished from other spindle-cell tumors.%目的：探讨乳腺纤维瘤病的临床病理学特征、免疫表型及诊断与鉴别诊断。方法回顾性分析36例乳腺纤维瘤病的临床表现、病理学形态及免疫组化特点，并复习文献。结果36例均为女性，发病年龄16~75岁，平均35岁。镜下肿瘤由梭形纤维母细胞和肌纤维母细胞构成，呈束状、编织状排列，可见不同程度的胶原化及玻璃样变。瘤细胞异型性不明显，核分裂像罕见。瘤组织呈特征性指突样浸润至病灶周围的正常组织。瘤细胞大多表达Vimentin、SMA，部分表达β-catenin，不表达CKpan、Desmin、S-100、ER、PR、CD34，Ki-67增殖指数约1℅。结论乳腺纤维瘤病为罕见的乳腺肿瘤，易误诊为乳腺癌，确切诊断必须依靠组织病理学检查，并与乳房其他梭形细胞病变进行鉴别。