分泌型乳腺癌的临床病理特征

目的：探讨乳腺分泌型癌的临床病理特征、诊断和鉴别诊断要点。方法 ：分析14例分泌型乳腺癌患者的临床病理资料，进行光镜观察，部分病例进行组织化学及免疫组化染色，并复习文献。结果：分泌型乳腺癌临床及病理大体观察与其他类型乳腺癌无明显区别，主要表现为乳房内肿块，多位于乳晕区，大体观察肿物大多连界不清、质地硬，光镜下肿瘤细胞主要排列成实性、小囊性和导管性三种结构，瘤细胞有颗粒性嗜酸性胞质，瘤细胞内外有大量均质嗜伊红PAS阳性分泌物。腋下淋巴结转移较少（2/14）。无局部复发或远处转移（随访3～14年）。结论：分泌型乳腺癌为罕见且预后较好的乳腺癌，确诊必须依靠病理检查。

Clinicopathological characteristics of secretory carcinoma of breast

Purpose To study the clinicopathological characteristics and differential diagnosis of secretory carcinoma of the breast. Methods Fourteen cases of secretory carcinoma were invesigated at the light microscopic level and some of them were studied by histochemical and immunohistochemical techniques,and the literatures were reviewed. Results There was no obvious difference between secretory carcinoma and other types of carcinoma of the breast in clinical and gross features. Most patients preasented with a palpable firm mass,often near the areola, and most tumors had infiltrating margin as seen on gross examination. Histologically the tumors revealed three patterns,namely,solid,microcystic and ductal,and appeared large amounts of intracellular and extracellular eosinophilic PAS positive secretory material,and the granular eosinophilic cytoplasm of the tumor cell. There were 2 patients with metastasis of the tumor in axillary lymph node(2/14). And there were no recurrence or late metastases (following up three to fourteen years). Conclusion Secretory carcinoma of the breast is a rare breast carcinoma and has better prognosis. Patholgic examination is only way for definite diagnosis.