Clinicopathological analysis of benign mammary ductal cystic papillomatosis with loss of myoepithelial cells / 中华病理学杂志

Objective: To investigate the histopathological and immunohistochemical characteristics of benign apocrine cystic papillary hyperplasia of the breast with loss of myoepithelial cell layer. Methods: The clinical data, histopathological features and immunohistochemical profile of patients with benign apocrine cystic papillary hyperplasia of breast with loss of myoepithelial cell layer from January 2016 to December 2021 were examined, in which six patients were identified. Results: All six patients were female, aged 36-61 years (median 46 years), who presented with a breast mass; three cases were from the left breast and three cases were from the right breast. Microscopic examination of all cases showed breast hyperplasia with apocrine cysts, accompanied by different degrees of micropapillary and papillary hyperplasia of apocrine cells. One case was associated with lobular carcinoma in situ, and one case was associated with apocrine ductal carcinoma in situ with intraductal dissemination in adenosis. Immunohistochemical staining of CK5/6, p63, SMA, SMMHC, Calponin and CD10 showed complete absence of myoepithelial cell layer surrounding ducts in apocrine cystic papillary hyperplasia. Conclusions: The myoepithelial cells of apocrine cystic papillary hyperplasia of the breast may undergo abnormal changes and may even be completely lost. The diagnosis should be comprehensively considered along with cytomorphological and histological features to avoid overdiagnosis.

Bilateral metastasis to the retina, choroids and optic nerve from breast cancer: a clinicopathological case.

A 39-year-old Asian woman, with a known history of breast cancer, presented with a gradual onset of painless reduction in vision in both eyes. Examination revealed visual acuity of counting fingers in the right eye and light perception in the left. There were subretinal lesions in the posterior poles of both eyes and retinal detachment in the left eye. Later she developed left proptosis and restriction in left ocular movement, most likely to be caused by metastatic extraocular spread. She subsequently died from disseminated metastatic disease. Histopathological examination confirmed tumor cells infiltrating the choroids, retina and optic nerve in both eyes. The tumor cells were arranged in lobular fashion and stained positively with Periodic Acid Schiff, suggesting the primary to be lobular adenocarcinoma type. Choroidal metastatic disease is common but bilateral retinal and optic nerve involvement with extraocular spread from breast cancer is rare.