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| 名称： | |
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- B1727Breast encapsulated (intracystic) papillary carcinoma (cqz 3)
图1
图2
图3
图4
| 姓 名： | ××× | 性别： | 年龄： | ||
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| 肉眼检查： | |||||
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？）
标签：乳腺囊内乳头状癌 EPC
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本帖最后由 于 2009-02-17 09:43:00 编辑
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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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本帖最后由 于 2008-11-12 23:28:00 编辑
图1
图2
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。
