文档介绍：冰冻切片在乳腺硬化型淋巴细胞性小叶炎鉴别诊断中的应用
【摘要】目的:分析乳腺硬化型淋巴细胞性小叶炎(SLL)与浸润性小叶癌及淋巴瘤在冰冻切片上的鉴别点。方法:结合文献回顾分析1例SLL患者的冰冻及HE切片的病理形态学表现及免疫组化结果,并与浸润性小叶癌及淋巴瘤进行鉴别。结果:巨检:组织灰白间灰黄色,质硬。镜检:冰冻切片上乳腺小叶萎缩、破坏,纤维组织增生伴胶原化,间质内小圆形细胞弥漫浸润,部分排列呈条索状、流水状。免疫组化检查:小圆细胞CD20(+),CD79α(+), CD3(+),CD45RO(+),CK(-),CK7(-),Ki67<1%。结论:硬化型淋巴细胞性小叶炎是良性炎症性病变,采用冰冻切片快速诊断极易与浸润性小叶癌及淋巴瘤混淆,必要时应行免疫组化检查加以鉴别诊断。
【关键词】乳腺硬化型淋巴细胞性小叶炎;冰冻;浸润性小叶癌
[ABSTRACT] Objective: To discuss the differential diagnosis for sclerosing lymphocytic lobulitis of breast from invasive ductal carcinoma and lymphoma in frozen section. Methods: The histopathological and immunohistochemical features of sclerosing lymphocytic lobulitis of breast were analyzed by HE staining and immunohistochemical assay. Results: The specimen was solid, yellowishwhite. Frozen section examination revealed atrophy and destruction of lobules and proliferation of fibrous stroma with hyalinization. Diffusely infiltration of small round cells, which sometimes were arranged in cords or strand
like patterns, were seen in the stroma. Immunohistochemical assay showed the small round cells were positive for CD20, CD79α, CD3, CD45RO(+) ,but negative for CK and CK7. The Ki67 labeling was less than 1%. Conclusion: Sclerosing lymphocytic lobulitis is a benign inflammatory lesion. This lesion is easily confused with invasive ductal carcinoma and lymphoma in frozen section. Immunohistochemical stain