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Objective@#To investigate the clinicopathologic features and possible causes of granulomatous lobular mastitis(GLM).@*Methods@#Three hundred cases of GLM were collected from surgical specimens diagnosed at Longhua Hospital, Shanghai University of Traditional Chinese Medicine from January 2015 to November 2017. Morphologic features were reviewed using HE staining. A total of 116 cases were investigated by Gram staining. The expression of CD3, CD20, CD68, IgG, IgG4, CD38 and CD138 was detected by immunohistochemical staining.@*Results@#The age of the patients was 23 to 47 years and the median age was 32 years. All patients were female, 96.7% (290/300) had a history of lactation.There were 143 cases of left breasts, 138 cases of right breast and 19 cases of bilateral breasts. Serum prolactin increased in 39.7%(119/300) patients. Within 15.7%(47/300) of patients were associated with nodular erythema or joint swelling and pain of the lower extremities. Pathological observation showed that lobular-centric suppurative granulomatous inflammation, accompanied by dilatation of intralobular and interlobular ducts. There were 16 cases accompanied with duct ectasia. Immunohistochemistry showed CD3-positive lymphocytes were more than CD20-positive lymphocytes in the peripheral aggregation zone of neutrophils within granulomatous lesions. Gram positive bacteria were found in the lipid vacuoles of the 51.7%(60/116) patients.@*Conclusions@#GLM has distinctive histologic features. It may be related to corynebacterium infection, or accompanied by the increase of serum prolactin and erythrocyte sedimentation rate. The age, location and history of the disease are importance in the diagnosis and differential diagnosis.
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Purpose To investigate the clinical pathological features, histologic features, and prognosis of solid papillary carcinoma ( SPC) of breast. Methods Nine cases of SPC of breast were analyzed by morphological observation, AB-PAS staining and immuno-histochemical MaxVision staining. The follow-up and analysis of the clinical datas of these nine cases were performed and relevant liter-atures were also reviewed. Results The age of 9 cases of SPC of breast ranged from 32 to 83 years old (mean age is 69. 2 years old). Three cases presented with nipple discharge. Nuclear levels of 9 cases were between low to mid-level. Seven cases were associated with intracellular and extracellular mucus secretion, two cases with calcification, and 3 cases with comedonecrosis. All of these nine cases were ER, PR positive and the positive rates were high ( >70%) , HER-2 was all negative. Syn expression in these nine cases were diffused positive except for one case showing focal positive, 4 with CgA diffused positive, 1 with partial positive and 4 were negative of CgA. Six patients had partial loss of the expression of myoepithelial markers, and 3 cases with complete myoepithelial expression. Ki-67 proliferation index was between 3% and 20%. Except for only one case with small area of invasive ductal carcinoma (IDC) (2 mm in great diameter) , all other cases were not associated with other types of breast cancer, sentinel lymph nodes and/or axillary/supracla-vicular lymph nodes metastasis. 8 patients accepted breast-conserving surgey, one case did not undergo radical mastectomy for small le-sion. All of these cases were accepted further endocrine drugs treatment and only one case accepted chemical therapy simultaneously because of the accompanied IDC. None of them was found to relapse for 3 to 61 months (mean 19. 6 months) of follow-up. Conclusion Nine cases of SPC of breast showed some characteristics such as relatively low nuclear level, often accompanied by intracellular and extracellular mucus secretion, positive for neuroendocrine marker, low lymph node metastasis rate, and no recurrence, which suggest that SPC may have a better clinical prognosis.
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<p><b>OBJECTIVE</b>To investigate the pathology, diagnosis and differential diagnosis of carcinomas arising in fibroepithelial neoplasms of the breast.</p><p><b>METHODS</b>Morphological observation and immunohistochemistry using MaxVision method were performed in fifty-four cases of carcinoma arising from fibroepithelial neoplasms of the breast from January 2003 to February 2014.</p><p><b>RESULTS</b>Thirty-eight cases of carcinoma arose from fibroadenomas. Twelve cases were classical lobular carcinoma in situ (LCIS). Twenty-one cases were ductal carcinoma in situ (DCIS), including four cases of low-grade, ten cases of intermediate-grade, six cases of high-grade and one case of apocrine. One case was mixed DCIS and LCIS. Three cases were infiltrating ductal carcinoma (IDC) accompanied with DCIS. One case was spindle cell metaplastic carcinoma. Sixteen cases arose from phyllodes tumours. Six cases arose from benign phyllodes tumours, including four cases of low-grade DCIS, one case of high-grade DCIS, and one case of classical LCIS with micro-invasion (diameter 0.9 mm). Three cases arose from borderline phyllodes tumours, including one case of classical LCIS, one case of intermediate-grade DCIS, and one case of invasive lobular carcinoma (ILC) with LCIS. Seven cases arose from malignant phyllodes tumours, including two cases each of low-grade DCIS and intermediate-grade DCIS, one case of high-grade DCIS, one case of apocrine DCIS, and one case of mixed IDC with DCIS. By immunohistochemistry, LCIS and ILC were diffusely positive for ER and PR. Low-grade DCIS was diffusely positive for ER and PR ( > 90%), intermediate-grade DCIS was 70%-90% positive, high-grade DCIS was negative for ER and 20%-30% positive for PR, apocrine DCIS was both negative, and IDC was 40%-90% positive. The spindle cell metaplastic carcinoma was negative for ER and PR, but showed diffuse or scattered positivity for CK5/6 and p63.</p><p><b>CONCLUSIONS</b>Carcinomas arising from fibroepithelial neoplasms of the breast are rare, showing unusual clinical presentation, and are characterized by in situ or invasive carcinomas in a background of fibroepithelial neoplasms. The accurate diagnosis depends on the recognition of the background fibroepithelial neoplasms and assessment of the nature of the epithelial proliferation, supplemented by immunohistochemistry when necessary.</p>
Subject(s)
Female , Humans , Breast Neoplasms , Pathology , Carcinoma in Situ , Pathology , Carcinoma, Ductal, Breast , Pathology , Carcinoma, Intraductal, Noninfiltrating , Pathology , Carcinoma, Lobular , Pathology , Immunohistochemistry , Neoplasms, Fibroepithelial , Pathology , Phyllodes Tumor , Pathology , Rare Diseases , PathologyABSTRACT
Purpose To investigate clinicopathological features,diagnosis and differential diagnosis of tubular carcinoma of the breast.Methods Morphological observation and immunohistochemistry were applied in 29 cases of tubular carcinoma of the breast, and the literatures were also reviewed.Results The tumors were composed of open tubules, infiltrating haphazardly in the cellular desmoplastic stroma. The neoplastic tubules were enclosed by a single layer of epithelial cells with insignificant atypia or rare mitoses.The tumors were often associated with lobular neoplasm, columnar cell lesion, ductal atypical hyperplasia or carcinoma in situ. Immunostaining displayed that myoepithelial cells were absent or incomplete.Conclusions Tubular carcinoma of the breast is a peculiar subtype of breast carcinoma with good prognoses, which is easily confused with microglandular adenosis, radial sclerosing lesions,or low grade invasive ductal carcinoma.Immunohistochemistry is useful for the differential diagnosis.
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Objective: To investigate the gene expression of bone morphogenetic protein(BMP)in human cervical disc.Methods:cervical disc specimen were obtained from patients undergoing anterior disc surgery,who had the signs of cervical disc herniation.Immunohistochemical and in situ hybridization studies were conducted to detect cells with BMP gene expression.Results:It showed positive staining of BMP-like immunohistoreactivity and its mRNA gene expression in degenerated discs,osteophytes,posterior longitudinal ligments,amd periosteum of vertebra.Conclusion:BMP may be relate to intervertebral disc degeneration as prolifertion-stimulating factor of chondrocytes that replace normal anular cells during disc degeneration but its mechanism needs further study.
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To study the clinicopathological features of breast carcinoma with responsive granuloma. MethodsFive cases of breast carcinomas with responsive granuloma were investigated by morphological observation. ResultsAll the five patients had noncaseating epithelioid granulomas. Multinucleated giant cells, predominantly of Langhans type, were present in granulomas. The granulomas were restricted to the carcinoma, and no responsive granulomas were evident in the regional lymph nodes. None of the patients had clinical evidence of systemic granulomatous disease. ConclusionDifferential diagnosis of breast carcinoma with responsive granuloma should include the carcinoma with osteoclast-like giant cells, metaplastic the carcinoma with osteoclastic giant cells, granulomatous lobular mastitis, stromal responsive giant cells, and carcinoma with sarcoidosis or tuberculosis of the breast.