1 武汉大学人民医院病理科，武汉 430060
Clinicopathological observation of metaplastic carcinoma combined with apocrine carcinoma of breast
CorrespondingAuthor: YUAN Jingping
This work was supported by the Science and Technology Planning Project of Wuhan, China (2017060201010172).
To investigate the clinicopathological features, immunophenotypic characteristics, diagnosis and differential diagnosis of special subtype breast cancer containing metaplastic carcinoma and apocrine carcinoma, a case of metaplastic carcinoma combined with apocrine carcinoma of breast was collected. The clinical manifestations, Color Doppler ultrasound, histopathology, immunophenotype and prognosis characteristics were analyzed, and the relevant literatures were reviewed for discussion. The clinical manifestations of a 62-year-old female patient were progressive enlargement of bilateral breast masses. Color Doppler ultrasound showed local glandular structure disorder and echo reduction in the left breast, and solid mass in the right breast with calcified plaque. Microscopically, the luminal nucleus of the left breast tissue was pleomorphic, large chromatin and obvious nucleoli. Nuclear fission was common, and the normal structure of the right breast was destroyed. The inner wall of the cyst was lined with squamous cells with different degrees of nuclear abnormity and polymorphism. Some tumor cells were composed of cancer cells differentiated from apocrine glands. Microscopically, the cytoplasm was rich and had acidophilic granules, and tumor cells had large nuclei and obvious nucleoli. The results of immunohistochemistry showed that P120 (membrane), E-cadherin, ER, PR and HER-2 were positively expressed, and CK5/6 was negatively expressed in the left breast tumor cells; in the right breast tissue, squamous cell carcinoma was negative for ER, PR and HER-2, but positive for CK5/6 and p63. The proliferation index of Ki-67 was about 40%. The carcinomas with apocrine differentiation was negative for ER and PR, but positive for AR, GCDFP-15 and HER-2. The proliferation index of Ki-67 was about 40%. Combined with the clinical data, breast Color Doppler ultrasound, histopathological features and immunohistochemistry results of the patient, metaplastic carcinoma combined with apocrine carcinoma of breast was diagnosed. Metaplastic carcinoma of the breast is a group of cancers with heterogeneous components. The diagnosis depends on histopathological features and immunophenotype. The main treatment is surgical resection.
breast neoplasms; metaplastic breast cancer; squamous cell carcinoma; apocrine carcinoma