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                淋巴结内上皮乳头状增生：其连续的形态学谱系与乳腺导管内乳头状瘤密切相关
    腋窝、骨盆、颈部这些主要引流部位的淋巴结，是偶然出现异位组织的潜在部位，与器官引流密切相关。淋巴结切除或者对癌症患者分期评估时发现的淋巴结内包含物，可能被误诊为转移性疾病.结内乳头状包含物由于其复杂的结构，较易模拟转移性疾病，诊断就更具有挑战性。纳什维尔范德堡大学医学研究中心病理科，我们发现6例经过组织病理学检查被证实的腋窝淋巴结乳头状包含物（上皮乳头状增生）。1例示不典型导管上皮增生，1例示低级别导管原位癌，1例示普通型导管上皮增生。相应的乳腺病变是乳头状瘤（5/6），不典型导管增生（2/6），低级别导管原位癌（3/6）.1例中级别的浸润性导管癌，其结内乳头状瘤缺乏不典型性。我们的研究结果表明：结内乳头状增生与乳头状瘤和非侵袭性乳腺肿瘤不一定就有直接的关系，结内包含物应被认为是一种有自己起源的独立性病变，而非转移性病变。 Am J Surg Pathol 2014,38(3):383-388.

Abstract: Lymph nodes, particularly those draining in major anatomic sites like axilla, pelvis, and neck are
potential sites for the occasional presence of ectopic tissue, usually representative of the organ being drained. Owing to the uncertainty surrounding the processes causing such findings, and particularly in the setting of lymph node dissection and sampling for cancer staging, intranodal epithelial inclusions, rare as they may be,
might be fertile soil for overdiagnosis of metastatic disease. Intranodal papillary inclusions are particularly problematic and challenging because of their complex architecture that may easily mimic a metastasis. From the files of the Breast Consultation Service, Department of Pathology at the Vanderbilt University Medical Center in Nashville, we identified 6 cases in which histopathologic examination of axillary lymph nodes revealed intranodal papillary inclusions (papillary epithelial proliferations). One case showed atypical ductal hyperplasia, showed low-grade ductal carcinoma in situ, and 1 showed usual ductal hyperplasia. The corresponding breast lesions were papillomas in 5 of 6 cases, 2 of which displayed atypical ductal  hyperplasia, whereas 3 showed low-grade ductal carcinoma in situ. One case showed intermediate-grade invasive ductal carcinoma, and the associated intranodal papilloma lacked atypia. Our findings suggest that intranodal papillary proliferations are often, although not exclusively, associated with papillary and noninvasive breast neoplasms, hence highlighting the origin of these intranodal lesions as independent de novo nodal processes rather than metastatic deposits.