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- B2300乳腺癌，类型？
Dr. XLJin8,
Your knew brest ca categories in details. Primary small cell carcinoma (SCC) is rare. I once saw one at AFIP. It was a classic case like lung or cervical scc. So I do not have much experience about scc. There is no large study in this area. It is true that the cytomorphologic features of this tumor share some similarity with classic scc. However, geneally we hope to see some good positivity for neuroendocrine markers before we call scc, such as ck56, chromogranin, synaptophysin,, NSE. This case is negative for CD56, CD57, synaptophysin. I did not see other neuroendocine marker positive also. Your case shows squamous differentiation. It may be scc, but I am not convinced now. If you want to have a unique diagnosis you must feel very comfortable for your dx. You have to exclude other reasonable diagnoses. Clinicians, patient and other patholoigsts will challenge your dxianosis.
I still favor the interpretaion of invasive ductal ca with basal-like phenotype and focal squamous differentiation. It can explain all morphologic and IHC features.
Sometime the simple or familar diagnostic term is easier to be accepted for most people especially in the situation without much difference for treatment.
Just for your reference,
Glad to know you in the web and thank for sharing your challenge case.
cz
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本帖最后由 于 2009-12-19 12:44:00 编辑
Dr. Zhao，您好！
非常感谢您的意见。 有关乳腺原发性小细胞癌的病例报道非常少，最大组为Shin和Rosen的9例，“Small cell carcinoma of the breast. A clinicopathologic and immunohistochemical study of nine patients. Am J Surg Pathol 2000;24:1231-1238。很抱歉，一开始没把NSE+ Crg-A+的图给出。我们还将做电镜，看看小细胞是否有神经内分泌颗粒。此外再标记一些其它的神经内分泌标记物。
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抗体 |
9例标记结果 |
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AE1/AE3 Cam5.2 CK7 CK19 CK20 Vimentin NSE Crg-A Syn Calcitonin Leu7 Gastrin releasing peptide Neurofilament Somatostatin Seretonin ER PR Her2/neu Bcl-2 CD56 P53 |
9/9 8/9 7/9 7/9 0/9 4/9 9/9 4/9 5/9 3/9 3/9 2/9 0/9 0/9 0/9 6/9 5/9 0/9 9/9 7/9 6/9 |
- xljin8
| 以下是引用XLJin8在2009-12-18 18:07:00的发言：
Dr. Chao，您好！ 非常感谢您的意见。 有关乳腺原发性小细胞癌的病例报道非常少，最大组为Shin和Rosen的9例，“Small cell carcinoma of the breast. A clinicopathologic and immunohistochemical study of nine patients. Am J Surg Pathol 2000;24:1231-1238。很抱歉，一开始没把NSE+ Crg-A+的图给出。我们还将做电镜，看看小细胞是否有神经内分泌颗粒。此外再标记一些其它的神经内分泌标记物。
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I am almost convinced by you. Many breast tumors can be focally positive for neuroendocrine markers.
Waiting for your EM result.
Thank you for sharing the interesting case.
