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- B111乳腺肿物，您怎么看？
引用 16 楼 oldlion 在 2013-04-09 20:49:44 的发言:
此例我个人意见倾向大汗腺腺病伴有非典型增生，正如雅马哈老师说的，我也是很纠结第9.10图，腔内红染的应该是分泌物不是坏死吧。会诊意见是：分泌性癌，仔细看图7.8等内确实有些分泌物，但是我感觉本例肌上皮很完整，应该不像浸润性癌，另外S-100染色基本是阴性的，只有肌上皮细胞阳性，所以有点不太明白，发上来请各位老师指点，谢谢。
刚开始我也考虑了分泌腺癌，尤其P63胞浆着色和分泌物着色这点是分泌性癌的特点，分泌性癌还应该S-100弥漫阳性，当然不是100%这样，但是必须是肌上皮标记阴性，本例肌上皮标记似乎明显是阳性的。分泌性癌在分子学上证实是基底细胞样癌亚型，但为预后极好的惰性肿瘤。正因为有基底细胞样癌的分子学特征，所以分泌性癌会不定表达基底细胞样癌的标记物如CK5/6、CK-H等等。本例正好P63和CK5/6都胞浆着色了，让人莞尔
肌上皮标记自己再加calponin、CD10看看，您的SMA特异性不好，万一是间质着色而非肌上皮咋办？
P63胞浆染色在分泌性癌中：
Secretory carcinoma of breast demonstrates nuclear or cytoplasmic expression in p63 immunohistochemistry.
Yonsei University Wonju College of Medicine, Wonju, South Korea.
Abstract
The aim of this study was to evaluate the pattern of p63 expression and its implication in secretory carcinoma of the breast. Immunohistochemical staining for p63, p53, MDM2, and smooth muscle actin was performed in 7 cases of secretory carcinomas. Nuclear expression of p63 was observed in 3 cases, whereas staining against cytoplasmic and intraluminal secretory material were observed in 4 cases. p53 was expressed in 3 cases and MDM2 in 2 cases. The loss of myoepithelial cells was confirmed by immunohistochemical stain for smooth muscle actin in invasive secretory carcinomas. The pattern of expression of p63 in secretory carcinoma of the breast was revealed in nuclei or cytoplasm/secretory materials.
