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ID:19907367
大小:8.71 MB
页数:82页
时间:2018-10-07
《生殖系统和乳腺疾病--乳腺癌及前列腺疾病》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、生殖系统和乳腺疾病(二)DiseasesofgenitalsystemandmammaryglandDepartmentofPathologySouthernMedicalUniversity7/7/20211Content*Carcinomaofbreast;Prostatichyperplasia7/7/20212乳腺癌Carcinomaofbreast7/7/202137/7/20214AnormalductcellsBbasementmembraneClumen(centerofduct)7/7/202157/7/202167/7/20217导管双
2、层上皮内腺上皮,外肌上皮Normallobuleofmammarygland7/7/20218全球每年120万妇女患乳腺癌,50万死于该病北美、北欧高我国↑3%/年,“第一癌症杀手”40-60岁女性,男性罕见1%乳腺外上象限>中央区>内上象限来自乳腺终末导管小叶单元上皮Introduction7/7/20219ER、PR(+):内分泌治疗好,预后好C-erbB-2(+),ER(-):预后差乳腺是女性激素的靶器官正常乳腺上皮细胞存在雌激素受体(ER)孕激素受体(PR)ER、PR→启动细胞分裂→促乳癌生长7/7/202110Thecellsofthisbrea
3、stcarcinomaarehighlypositiveforestrogenreceptorwiththisimmunoperoxidasestain.Estrogenreceptorpositivitycorrelateswithabetterprognosis.7/7/202111Thisisprogesteronereceptor(PR)positivityinabreastcarcinoma.Theusefulnessofthisdeterminationisnotaswellestablishedasforestrogenreceptors.C
4、arcinomasthatarePRpositive,butnotERpositive,mayhaveaworseprognosis.7/7/202112分类:乳腺癌非浸润性癌浸润性癌导管内原位癌小叶原位癌粉刺癌非粉刺导管内癌Paget病浸润性导管癌浸润性小叶癌特殊类型癌小管癌典型髓样癌粘液癌7/7/202113属于原位癌没有突破导管和腺泡的基底膜分类:导管内原位癌小叶原位癌一、非浸润性癌7/7/2021141.导管内原位癌(Intraductalcarcinomainsitu)起于乳腺小叶的终末导管限于导管内,基膜完整检出率↑,5%-15%-30%组织学
5、:粉刺型,非粉刺型20年,30%-浸润癌7/7/202115AnormalductcellsBductalcancercellsCbasementmembraneDlumen(centerofduct)7/7/202116Intraductalcarcinoma.Theneoplasticcellsareconfinedtotheductbythebasementmembrane.Theneoplasticcellsaremonotonouswithroundtoovalnucleiandlittlepleomorphism.Thecellbordersa
6、rewelldemarcated.7/7/202117(1)粉刺癌(Comedocarcinoma)>50%位于乳腺中央部质硬、肿块明显,易触诊查出导管扩张,内含坏死物质挤压导管,坏死物质会像粉刺一样被挤出7/7/202118镜下:实性排列,中央坏死-特征癌细胞大,嗜酸,大小不一,核仁明显,病理性核分裂多坏死区常见钙化导管周间质纤维组织↑,慢性炎C浸润7/7/202119Comedocarcinomaischaracterizedbythepresenceofrapidlyproliferating,high-grademalignantcells.The
7、cellsinthecenteroftheductsareoftennecroticandcalcify.Thiscentralnecrosisleadstothegrosscharacteristicofextrusionofcheesymaterialfromtheductswithpressure.7/7/2021207/7/202121ComedocarcinomaNotecentralnecrosis(*)andpleomorphicnuclei.Thecellsdonotextendbeyondthebasementmembrane(arrow
8、).7/7/202122Thecenteroftheductcon
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