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- B2-13(美国Rochester大学)
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读片会讨论意见：
1：黏液癌
2：实性乳头性癌，加染Syn, CgA, NSE
3：黏液癌，部分为微乳头状癌
4：乳头状癌，加染CgA, Syn
5：大汗腺样的粘液癌（CNB标本）
6：mucinous carcinoma (or intermediate to high grade IDC, need to rule out invasive micropapillary (EMA - highlight periphery in invasive micropapillary) ? also some neuroendocrine differentiation (synaptophysin, chromogranin?)
7：粘液腺癌，部分为浸润性微乳头状癌
8：黏液癌伴浸润性微乳头状癌结构
9：粘液腺癌
10：粘液癌
11：浸润性微乳头状癌，伴有黏液分泌
12：invasive micropapillary carcinoma with mucinous differentiation. (This is a high grade tumor, need to be distinguished from invasive mucinous carcinoma)
13：疑为为乳头型DCIS？粘液癌？组织过少
14： 浸润性粘液癌
出片单位意见：Invasive mucinous carcinoma with micropapillary pattern
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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tangping123 离线
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本帖最后由 于 2010-08-04 18:35:00 编辑
The histology of the lesion show both mucinous and micropapillary features, with both mucin and the inverted pattern very easy to appriociated. Recently most people included us like to call it as mucinous carcinoma with micropapillary feature. Some has named it as mucinous variant of invasive micropapillary carcinoma. Either way, it's prognosis is believed to be worse than pure mucinous carcinoma, and probably better than IMPC. So mention it in diagnosis is important.
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本帖最后由 于 2010-08-04 18:55:00 编辑
唐平教授提供一篇文献，摘要：
Prognostic Significance of
Micropapillary Pattern in Pure
Mucinous Carcinoma of the Breast
Amanjit Bal, MD, DNB, Kusum Joshi, MD, MAMS, PhD, FICPath,
Suresh Chander Sharma, MD, Ashim Das, MD, FRCPath,
Alka Verma, MSc, MLT, and Jai Dev Wig, MS, FRCS, FAMS
Breast carcinoma with micropapillary architecture is associated with aggressive behavior. Similar micropapillary pattern in pure mucinous carcinoma has been noticed and has been shown to convey poor prognosis. In this study 17 cases of pure mucinous carcinoma of the breast seen during a 10-year period have been reviewed, with special reference to micropapillary pattern. Diffuse micropapillary pattern was seen in 6 of 17 cases of mucinous carcinoma of the breast and demonstrated reverse polarity immunostaining pattern with “Epithelial Membrane Antigen.” In all cases, the tumor cells showed grade I morphology, and no lymph node metastases were noticed. All the tumors except 1 expressed strong estrogen and progesterone receptor expression, however, all the cases were negative for Her-2/neu expression. In this present study, mucinous carcinomas with micropapillary pattern showed a low nuclear grade, higher incidence of hormone receptor positivity, and lower incidence of Her-2/neu similar to mucinous carcinomas without micropapillary pattern, thus explaining their indolent behavior.
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。
