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- B2160浸润性导管癌伴大汗腺特征,morphology like histiocytoid or granular cell tumor (cqz-24) 7-16-2009
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Breast Cancer. 2002;9(1):43-9.
Histological and immunohistochemical analysis of apocrine breast carcinoma.
Matsuo K, Fukutomi T, Hasegawa T, Akashi-Tanaka S, Nanasawa T, Tsuda H.
Department of Surgical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5-chome, Chuo-ku, Tokyo 104-0045, Japan.
BACKGROUND: There are few data regarding the biological characteristics of apocrine breast carcinoma in the literature due to its rarity and controversy over its definition. We analyzed the histopathological characteristics and tumor biology of apocrine breast carcinomas with regard to histological grade, p53, HER2, bcl-2, MIB-1 and hormone receptor status. PATIENTS AND METHODS: A consecutive series of 24 female apocrine breast carcinoma patients were the primary source of these retrospective data. Background factors including histological grade, nodal status and lymphatic invasion by tumor cells were analyzed. Immunohistochemical staining for p53, HER2, MIB-1, bcl-2, estrogen receptor (ER) and progesterone receptor (PR) was carried out on formalin-fixed, paraffin embedded specimens. RESULTS: Older age and postmenopausal status were observed more frequently in patients with apocrine breast carcinoma than those with invasive ductal carcinoma. Apocrine breast carcinoma also showed relatively lower histological grade than invasive ductal carcinoma. Nuclear accumulation of p53, HER2 overexpression, bcl-2 and MIB-1 index were observed in 29% (7/24), 33%(8/24), 25%(6/24) and 29% (7/24) of cases, respectively. Positivity for ER and PR was present in 17% (4/24) and 17% (4/24) of cases, respectively. CONCLUSIONS: Apocrine breast carcinoma tended to show low MIB-1 index, low bcl-2 expression and low positive rate of hormone receptors. There was no correlation between the three types of apocrine carcinoma and the positivity rate of p53, HER2, bcl-2, MIB-1 and hormone receptor status.
PMID: 12196721 [PubMed - indexed for MEDLINE]- 该研究组中，免疫组化HER2阳性率33%(8/24)。
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华夏病理/粉蓝医疗
为基层医院病理科提供全面解决方案，
努力让人人享有便捷准确可靠的病理诊断服务。
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Histopathology. 2004 Apr;44(4):332-8.
Preferential HER-2/neu overexpression and/or amplification in aggressive histological subtypes of invasive breast cancer.
Varga Z, Zhao J, Ohlschlegel C, Odermatt B, Heitz PU.
Department of Pathology, University Hospital Zurich, Zurich. zsuzsanna.varga@usz.ch
AIMS: To investigate whether alterations of the HER2 gene occur more frequently in histologically unfavourable subtypes of invasive breast cancer. METHODS: The study was composed of nine invasive apocrine, six lipid-rich, 12 glycogen-rich, 11 micropapillary and 33 pleomorphic lobular breast carcinomas. Lymph node involvement was represented in all subgroups. HER2 status was confirmed in all cases by using immunohistochemistry (CB11, Herceptest) and fluorescent in-situ hybridization (FISH) analysis (Vysis). RESULTS: Micropapillary and apocrine carcinomas showed the highest rate of protein overexpression (72% and 66%) and gene amplification (45% and 44%). Protein overexpression was common in poorly differentiated pleomorphic lobular carcinomas (56%); however, this subgroup failed to show an increased number of gene copies by FISH (31%). The incidence of HER2 overexpression (33% and 50%, respectively) and gene amplification (25% and 33%, respectively) among glycogen-rich and lipid-rich carcinomas was not higher than that observed in breast cancer generally. CONCLUSION: Our data suggest that preferential involvement of the HER2 gene in micropapillary and apocrine breast carcinomas may contribute to their aggressive behaviour.
PMID: 15049898 [PubMed - indexed for MEDLINE]- 该研究组中，微乳头型和大汗腺型癌的HER2蛋白表达率(72% and 66%) 和基因扩增率(45% and 44%)最高，可能是其预后差的原因。
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华夏病理/粉蓝医疗
为基层医院病理科提供全面解决方案，
努力让人人享有便捷准确可靠的病理诊断服务。
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本帖最后由 于 2009-08-15 20:06:00 编辑
Thank Abin for your contribution for this case. We signed out this biopsy case as invasive ductal carcinoma with apocrin feature. Apocrine ca is a subtype of ductal ca. Basically invasive apocrine ca and invasive usual ductal ca have similar prognosis.
As Abin mentioned classic IHC of apocrin ca: GCDFP-15+, BCL 2-, ER-, PR-.
Interesting part for this case is the morphologic features in breast core biopsy. The breast core bx specimen demonstrated the cytomorphologic features more like granular cell tumor, histiocytic lobular ca. The metastatic tumor in axillary lymph node has some features of apocrine tumor.
Thank all of you who read and attended the discussion for this case.
cz
abin译：
谢谢abin为本例的贡献。我们活检签发的是浸润性导管癌伴大汗腺特征。大汗腺癌是导管癌的一个亚型。浸润性大汗腺癌和浸润性导管癌有相似的预后。
正如abin提到的，大汗腺癌典型的免疫组化：GCDFP-15+, BCL 2-, ER-, PR-。
本例有趣之处在于，粗针穿刺活检时的形态学特征：细胞形态学特点更像颗粒细胞瘤和组织细胞样小叶癌。腋窝淋巴结转移肿瘤有大汗腺肿瘤的某些特征。
谢谢所有阅读并参与讨论的人。
cz
