Interesting case.

I cannot see the tumor edge in above photos. My differential dx includes ruptured cysts with a granulomatous reaction, a histiocytic tumor, apocrin carcinoma, and granular cell tumor (GCT). The cytomorphology of the last two photos are really consistent with GCT.

Suggest IHC:

Pan cytokeratin, EMA: mammary ca is positive, histiocyte or GCT is negative

S-100: strongly positive for GCT

alpha-antitrypsin: Histiocytes are positive, GCT is negative.

CD68: Strongly and diffusely positive for histiocyte; GCT may be focal positive or negative

Hope to see your follow-up

大概翻译:

上述图片中我看不到肿瘤的边界,

我认为需要鉴别的鉴别诊断包括囊肿破裂引起的肉芽肿反应;

组织细胞肿瘤, 分泌性癌, 颗粒细胞瘤

最后两张的图片上看该细胞形态学,符合颗粒细胞瘤.

建议免疫组化:

CK-P,EMA乳腺癌是阳性的,组织细胞或颗粒细胞是阴性的

S-100:   颗粒细胞为强阳性

alpha-antitrypsin   组织细胞是阳性的,颗粒细胞是阴性的

CD68:  组织细胞是广泛的强阳性,颗粒细胞是局灶的阳性或阴性的