摘要
目的探讨乳腺肌样错构瘤（myoid harmatoma,MH）的临床病理特征及生物学行为。方法收集5例MH,进行组织病理学、免疫表型及电镜观察。结果 5例发病年龄29~44岁,平均39岁。肿瘤直径1.4~2.0 cm,平均1.7 cm。镜检：3例边界清楚,2例边界不清。肿瘤均由不同比例的乳腺腺泡、导管,肌样细胞束,纤维间质及脂肪组织组成。肌样细胞束散在灶性分布于纤维脂肪间质之中（4例）,或与间质弥漫片状混合（1例）。肌样细胞类似于平滑肌细胞（1例）或肌纤维母细胞（4例）。免疫表型：5例肌样成分均表达desmin,α-SMA,MSA。电镜检查：1例显示肌纤维母细胞分化。5例均行肿块切除术,2例局部复发。结论 MH是乳腺错构瘤的少见亚型,以呈平滑肌或肌纤维母细胞分化的肌样细胞束为典型特征。肌样细胞表达平滑肌标记,而超微结构上可能显示肌纤维母细胞分化。少数MH存在复发潜能;需局部广泛切除,保证切缘阴性。
Purpose To elucidate the clinical behaviors and clinicopathologic features of myoid harmatoma（MH）.Methods The clinical and pathological characteristics of five cases of MH were reviewed.Immunohistochemical and ultrastructural study was performed.Results Five patients ranged in age from 29 to 44 years（mean,39）.Grossly,the tumors ranged from 1.4 cm to 2.0 cm（mean,1.7 cm）in size.Microscopically,three lesions were sharply demarcated;two lesions were ill-defined.All tumors were composed of breast epithelium,myoid cell bundles,fibrous and fatty tissues in various proportion.The myoid element was scattered（four cases）or mingled more diffusely with the fibro-fatty stroma（one case）.The myoid cells produced the features of smooth muscle cells（one case）or myofibroblasts（four cases）.Immunohistochemically,the myoid cells were positive for desmin,α-SMA and MSA in all tumors.Ultrastructural study of one case exhibited myofibroblastic differentiation.Five patients underwent local excision.Local recurrence observed in two cases.Conclusions Breast myoid hamartoma is characterized by the presence of myoid cell bundles showing smooth muscle or myofibrobalstic differentiation.The myoid component expresses smooth muscle markers,and might show myofibroblastic differentiation ultrastructurally.This study indicates that potential recurrence may occasionally occur in MH.Wide local excision and negative margins should be warranted.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2010年第3期275-279,285,共6页
Chinese Journal of Clinical and Experimental Pathology
基金
复旦大学研究生创新基金资助(NoEYF159024)
关键词
乳腺肿瘤
错构瘤
肌样分化
复发潜能
breast tumor
hamartoma
myoid differentiation
recurrence potential
