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B1727Breast encapsulated (intracystic) papillary carcinoma (cqz 3)

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楼主 发表于 2008-11-12 11:49|举报|关注(1)
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I transfer this case from previous breast lesion. Hope more people see and join in the discussion:

(这个病例是从以前一个乳腺病例的帖子中转移过来的。希望更多人看到并且参与讨论。) 

50 year women with breast mass

(女,50岁,乳腺肿块)  

Fig 1 is a low power view of the lesion, where the overlying skin adjacent to the nipple is seen overlying a well-circumscribed mass.
(图1 低倍,乳头附近的皮肤下方见界清肿块)
Fig 2 mid power
Fig 3 Hihg power
Fig 4 p63 stain
What is your diagnosis or differential dx?
(您的诊断和鉴别诊断?)
  • Breast encapsulated (intracystic) papillary carcinoma (cqz 3)图1
    图1
  • Breast encapsulated (intracystic) papillary carcinoma (cqz 3)图2
    图2
  • Breast encapsulated (intracystic) papillary carcinoma (cqz 3)图3
    图3
  • Breast encapsulated (intracystic) papillary carcinoma (cqz 3)图4
    图4
标签:乳腺囊内乳头状癌 EPC
本帖最后由 于 2009-02-17 09:43:00 编辑
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×参考诊断
囊内乳头状癌

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1 楼    发表于2009-02-03 11:51:00举报|引用
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 第二例是否伴有神经内分泌分化? Good question. IHC did not show neuroendocrine features of this tumor.
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2 楼    发表于2008-11-22 09:54:00举报|引用
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以下是引用快乐病理人在2008-11-22 9:23:00的发言:

 导管内乳头状癌是否发生转移?

 

Intraductal papillary carcinoma is a type of DCIS. Generally it does not cause metastatic lesion.

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3 楼    发表于2008-11-18 11:45:00举报|引用
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Two cases of EPC with collagen IV stain (periphery of the tumor nodule).
  • 图1
  • 图2
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4 楼    发表于2008-11-18 11:42:00举报|引用
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 Great. Most of u got the answer. Both of the cases are intracystic papillary carcinoma.

The H&E slide in the second case is not very good. You can see it more clearly in the p63 stained slide, which demonstrates papillary glandular structure. The pattern is not like solid papillary ca. I discuss a lot about the features of solid papillary ca (SPC) in one case recently. But I cannot find it now.

Intracystic papillary ca is called encapsulated papillary ca (EPC) now. Microscopically, it is characterized by one nodule of papillary ca surrounded by a thick fibrous capsule. The histologic apperance of the papillary proliferation can have any of the features of papillary DCIS. Myoepithelial cells are not present in the papillae of EPC, same as in papillary DCIS. However, in contract to papillary DCIS, myoepithelial cells are also absent in the periphery of the tumor nodule of EPC. This is the most important feature of EPC. See my above two cases. Currently most people consider the lesion is a vaiant of papillary DCIS, even though some think it may represent a low grade invasive carcinoma. Studies have demonstrate that EPCs have excellent prognosis with adequate local therapy alone. One of our fellows recently demonstrated that collagen IV stain may be useful for differential dx of EPC. The stain is positive in EPC, but negative for invasive carcinoma.

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5 楼    发表于2008-11-12 12:09:00举报|引用
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本帖最后由 于 2008-11-12 23:28:00 编辑

Now I share a second case with same diagnosis as above case.

H&E and p63 stain.

Whoever saw the case please write down what you think and join in the discussion.

These photos will be published soon. Please do not copy them for your publication.

How can I add a marker to the photos like in the lecture photos? Then others cannot copy them.

Abin: Can u help to do it

Thanks,

cz

 

abin译:

我现在分享第二例,与上一例诊断相同。图为HE和p63染色。

希望看到的朋友都写下自己的思考,参与讨论。

这些图将要发表,请不要复制。

  • 图1
  • 图2
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6 楼    发表于2008-11-12 11:54:00举报|引用
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本帖最后由 于 2008-11-12 23:25:00 编辑

 I copied the previous discussion here:

我把以前参加的讨论复制过来:

 

Lili0321 按标记结果,要考虑浸润性乳头状癌。

故乡  P63染色阴性,细胞有异型,考虑导管内乳头状癌。

LiLI:  另外,还要除外皮肤汗腺发生的腺癌。

Abin: 组织学和IHC符合囊内乳头状癌。这些图未显示浸润。同意楼上,要排除皮肤附件来源的癌。谢谢。

笃行者 哈哈!大家讨论的太精彩了!受益匪浅!谢谢!该例也加精了。

欢迎继续讨论。

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