乳腺恶性叶状肿瘤伴平滑肌瘤临床病理观察

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摘要目的探讨乳腺恶性叶状肿瘤及平滑肌瘤的临床及病理特征、诊断及鉴别诊断。方法对1例乳腺恶性叶状肿瘤伴发平滑肌瘤病例进行临床、组织学形态和免疫组化染色观察，并复习文献。结果恶性叶状肿瘤主要组织学表现为良性的上皮成分及丰富的异型的纤维性间质细胞，部分形成叶状结构突入囊腔，挤压上皮形成裂隙状，免疫组化：Vimentin+。平滑肌瘤主要组织学表现为大量平滑肌束交错排列，细胞梭形，呈栅栏状、席纹样排列；免疫组化：SMA+、Desmin+、Vimentin+。结论恶性叶状肿瘤及乳腺平滑肌瘤均为乳腺少见肿瘤，同时伴发更为罕见。它们均有特征性的临床病理表现，且需要与乳腺的交界性及其他恶性肿瘤相鉴别。

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	南楠
	李志义

关键词 ：乳腺, 恶性叶状肿瘤, 平滑肌瘤, 病理特征, 免疫组化

Abstract：Objective To explore the clinical and pathologic features，diagnosis，differential diagonisis of the breastmalignant phyllodes tumor and leiomyoma.Methods A case of breastmalignant phyllodes tumor and leiomyoma was studied clinically，histopathologically with immunohistochemically，and the related literatures were reviewed as well.Results Themajor organizational performances of themalignant phyllodes tumor were benign epithelial components and rich fibrous stromal cells which formed leaf structure and protruded into the cavity.Immunohistochemical tumor cells in Vimentin was positive.Leiomyoma was composed of a large number of smooth muscle cells in the staggered arrangement，herringbone structure.Immunohistochemical tumor cells in SMA，Desmin and Vimentin were positive.Conclusion Breast malignant phyllodes tumor and leiomyoma are rare neoplasm，it ismore rare that happened at the same time.They all have characteristic clinical and pathological features，and wemust find the difference with other borderline ormalignant tumors.

Key words： Breast Malignant phyllodes tumor Leiomyoma Pathologic feature Immunohistochemistry

作者简介: 南楠（1980-），女，河北南皮人，硕士，主治医师，研究方向：肿瘤病理，擅长临床病理诊断，尤其在肿瘤病理及肾脏穿刺病理方面

引用本文:

南楠;李志义. 乳腺恶性叶状肿瘤伴平滑肌瘤临床病理观察[J]. 中国当代医药, 2016, 23(24): 142-144转147.
NAN Nan;LIZhi-yi. Clinical and pathological study on malignant phyllodes tumor and leiom yoma of breast. 中国当代医药, 2016, 23(24): 142-144转147.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2016/V23/I24/142

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