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- B2229breast 髓样癌, yes or no?(cqz-26) 9-1-2009
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标签：乳腺不典型髓样癌 基底细胞样乳腺癌
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本帖最后由 于 2009-09-26 08:24:00 编辑
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| 以下是引用cqzhao在2009-9-6 21:01:00的发言： Hope you will not become more confused after you read above abstracts. If we want to know a subject or topic really, we have to read related original publications. It is not enough to read some description in text book only. 谢谢赵老师的指点！ |
| 以下是引用abin在2009-9-4 23:23:00的发言：
WHO 2003 关于髓样癌有5个诊断特征，本例都符合。 典型的MC具备五大形态特征： |
This case may be called as 不典型髓样癌（AMC）based on the traditional criteria. Clearly the tumor cells demonstrate the focal infiltrating margins.
1. The term of medullary ca (MC) is confusing. The pathologic diagnosis is very subjective and interobservers are very variable. Basically many pathologists do not use the term any more. We did not make any diagnosis of MA in the past three years. Its prognostic implications are not certain.
2. In fact most of MA are triple negative and some basal-like marker positive, and belong to the category of basal-like ca, the same as most metaplastic ca.
3.We just call invasive ductal carcinoma for these cases because we do not give oncologists' impression that they have good prognosis.
4. For above case:
a. sentinel lymph node was positive
b. IHC: ER very focal positive: H score 4%, PR negative, Her2 score 2
c. Her2 Fish 2.03 , equovical.
5. Finally, I released this case as:
Invasive ductal carcinoma, Nottingham histologic grade (NHG) 3 (tubule formation-3, nuclear degree-3, mitotic activity-3, total score 9/9).
6. Home message for this case: The use of the diagnostic term of MC is contradict now. At least you need to be cautious to make the diagnosis of MC.
I just mention how we handle these kinds of cases now. It does not mean it is the only correct way.
Just for your reference.
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