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- B4002乳腺肿物
女、45岁 送检肿物2.5*2*2
冰冻切片：http://www.ipathology.cn/channel/detail/name/bbs/article/408081.html
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标签：纤维腺瘤伴多核间质巨细胞 叶状肿瘤
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在纤维肿瘤中间质的特有的分化是不常见的，这些包括平滑肌分化和脂肪分化。大多数伴有脂肪分化的纤维上皮性肿瘤属于叶状肿瘤。巨细胞，多核细胞有时可见于纤维腺瘤、叶状肿瘤和其他乳腺良性肿瘤的间质里。这些多核巨细胞的核可以是多型性的染色质可以是深染的，在有些肿瘤里，这些细胞形成编织状。这些多核细胞和纤维母细胞有相同的超微结构。有作者研究报告巨细胞对CD68是阳性的，少数细胞对actin or CD34有反应。有报告称多核间质巨细胞对
p53 and Ki67有免疫反应。尽管有这些非典型现象，但这些细胞的出现并不影响临床进程。并不意味间质里出现了多核巨细胞就把含有这种结构特点的纤维腺瘤通归纳与叶状肿瘤。骨软骨化生在纤维腺瘤是罕见的，它通常发生在绝经后的妇女。
引用 4 楼 lvgq 在 2012-03-16 20:35:05 的发言:
本帖最后由 lvgq 于 2012-03-16 20:43:45 编辑
Fig. 8.11. Fibroadenoma with stromal giant cells. A: Cells with hyperchromatic nuclei are present in pseudoangiomatous stromal hyperplasia in a fibroadenoma. B: Multinucleated stromal giant cells in another tumor.
Uncommon forms of stromal differentiation are encountered in a minority of fibroadenomas. These include smooth muscle (myoid) metaplasia (51) (Fig. 8.10) and adipose differentiation. Most fibroepithelial tumors with adipose differentiation are phyllodes tumors (52). Giant cells, sometimes with multiple nuclei, are found in the stroma of fibroadenomas (53,54) as well as in phyllodes tumors (54) and other benign breast tumors (55). The nuclei of multinucleated stromal giant cells may be pleomorphic and hyperchromatic (Fig. 8.11). In some tumors these cells to have a florette pattern. These multinucleated cells have ultrastructural features consistent with fibroblasts. In cases studied by the author, the giant cells were reactive for CD68, a histiocytic marker, and only a minority of these cells were immunoreactive for actin or CD34. Multinucleated stromal giant cells are reportedly immunoreactive for p53 and Ki67 (55). Despite their atypical cytologic appearance, the presence of these cells does not influence the clinical course of the lesion. A tumor that has the structural features of a fibroadenoma should not be classified as a phyllodes tumor because the stroma contains multinucleated stromal giant cells. Osteochondroid metaplasia in a fibroadenoma is very uncommon and it almost always occurs in postmenopausal women (56,57).
和上面的有点像！看不懂，谁把上面的文献翻译一下，谢谢！
该例纤维腺瘤的结构不明显
但是乳腺的小叶外间质中是可以出现多核巨细胞的
仔细分析这一例，小叶结构尚存，所以此时尽管多核巨细胞有异形，仍考虑良性
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本帖最后由 lvgq 于 2012-03-16 20:43:45 编辑
Fig. 8.11. Fibroadenoma with stromal giant cells. A: Cells with hyperchromatic nuclei are present in pseudoangiomatous stromal hyperplasia in a fibroadenoma. B: Multinucleated stromal giant cells in another tumor.
Uncommon forms of stromal differentiation are encountered in a minority of fibroadenomas. These include smooth muscle (myoid) metaplasia (51) (Fig. 8.10) and adipose differentiation. Most fibroepithelial tumors with adipose differentiation are phyllodes tumors (52). Giant cells, sometimes with multiple nuclei, are found in the stroma of fibroadenomas (53,54) as well as in phyllodes tumors (54) and other benign breast tumors (55). The nuclei of multinucleated stromal giant cells may be pleomorphic and hyperchromatic (Fig. 8.11). In some tumors these cells to have a florette pattern. These multinucleated cells have ultrastructural features consistent with fibroblasts. In cases studied by the author, the giant cells were reactive for CD68, a histiocytic marker, and only a minority of these cells were immunoreactive for actin or CD34. Multinucleated stromal giant cells are reportedly immunoreactive for p53 and Ki67 (55). Despite their atypical cytologic appearance, the presence of these cells does not influence the clinical course of the lesion. A tumor that has the structural features of a fibroadenoma should not be classified as a phyllodes tumor because the stroma contains multinucleated stromal giant cells. Osteochondroid metaplasia in a fibroadenoma is very uncommon and it almost always occurs in postmenopausal women (56,57).
和上面的有点像！看不懂，谁把上面的文献翻译一下，谢谢！
