发现左乳肿块半年

手术所见：外下象限可触及约3*3厘米大小肿块，质中，界欠清，无压痛

临床诊断：左乳肿块

Case Report.Primary small cell carcinoma of the breast with TTF-1 and neuroendocrine marker expressing carcinoma in situ. Michael Christie1, Laura Chin-Lenn2, Monique M. Watts3, Alpha E. Tsui1, Malcolm R.

Abstract: Primary small cell carcinoma (SmCC) of the breast is very rare and may be difficult to distinguish from metastatic small cell carcinoma. Confident histopathological diagnosis of a primary breast SmCC requires the demonstration of an in situ component. We report a case of primary small cell carcinoma of the breast with coexisting carcinomain situ in which the invasive carcinoma and in situ component both expressed neuroendocrine markers and Thyroid transcription factor-1 (TTF-1) by IHC. Expression of neuroendocrine markers and TTF-1 in the in situ component allowed a highly confident diagnosis of primary small cell carcinoma of the breast. To our knowledge there is only one previous report of TTF-1 expressing in situ carcinoma associated with a primary SmCC of the breast.

根据此文献复习已有2例乳腺原发性小细胞癌表达TTF-1。本例报道中的小细胞癌和导管原位癌二种成分均表达TTF-1。

1. Appl Immunohistochem Mol Morphol. 2010 Mar;18(2):142-9.Comparison of thyroid transcription factor-1 expression by 2 monoclonal antibodies in pulmonary and nonpulmonary primary tumors.
Matoso A, Singh K, Jacob R, Greaves WO, Tavares R, Noble L, Resnick MB, Delellis  RA, Wang LJ.
Department of Pathology and Laboratory Medicine, Rhode Island Hospital and Brown Medical School, Providence, RI 02903, USA. amatoso@lifespan.org Thyroid transcription factor-1 (TTF-1) is a transcription factor that plays a role in the development and physiology of the thyroid and lungs. Expression of TTF-1 is used as a marker of lung and thyroid clinically. Commercially available clones of TTF-1 monoclonal antibodies, 8G7G3/1 and SPT24, have been reported to have different sensitivities for the detection of neoplasms of different origins.Although they are used extensively in daily practice, a comprehensive comparative study of these antibodies in a wide variety of neoplasms is lacking. We examined TTF-1 expression in primary tumors of the lung, prostrate, pancreas, stomach,salivary glands,breast, bladder, colon, and squamous cell carcinoma of the head and neck and compared the results obtained with both TTF-1 clones. The SPT24 clone detected more primary lung tumors of all histologic subtypes. Importantly, the SPT24 clone detected a significantly higher number of squamous cell carcinomas and carcinoid tumors of the lung. Among nonpulmonary primary tumors, a significant number of invasive urothelial carcinoma of the bladder (5.1%) was TTF-1 positive. In addition, a small proportion of prostate (1.2%), stomach (0.9%), salivary gland (1.8%), and colon (2.5%) carcinomas were positive with both clones. Of note, both clones stained the same nonpulmonary tumors with similar intensity and distribution. Carcinomas of the pancreas, breast, and squamous cell carcinomas of the head and neck were negative with both clones. In summary, the SPT24 clone detected a higher number of pulmonary non-small cell tumors of all histologic subtypes whereas both clones stained a similar proportion of nonpulmonary tumors.

TTF-1有二珠单克隆抗体，二者的表达有些差异。但是本文作者的研究中乳腺癌均不表达TTF-1。