免疫組織染色で診断した男子非浸潤性乳管癌の1例 [in Japanese] A CASE OF MALE DUCTAL CARCINOMA IN SITU DIAGNOSED USING IMMUNOHISTOCHEMICAL STAINING [in Japanese]
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症例は60歳，男性．2003年頃より左胸のしこりを認めた．次第に増大するため2007年3月当科受診．受診時の身体所見では左E領域を中心に径4cm大，境界明瞭平滑，ほぼ球形の腫瘤を触れた．腋窩リンパ節は触知しなかった．穿刺細胞診ではCLASSIII，乳頭状病変:Intraductal papilloma疑いの診断であった．2007年4月左乳房切除術施行．病理組織診にて，CK5/6，p63，CD10，CK14，SMAは増殖細胞に陰性，SYN，CGA，CD56は陰性，ERびまん性陽性，S-100Pは極少数散在性に陽性核を認めた．34βE12は腫瘍細胞内にモザイク状陽性．MIB1染色では増殖活性は強めであった．以上よりNoninvasive ductal carcinoma of male breastと診断した．男子乳癌は少なくその中でも非浸潤癌は稀であり，若干の文献的考察をふまえ報告する．
The patient was a 60-year-old man who developed a lump in the left breast in 2003. He visited our clinic in March 2007 due to the gradual enlargement of the lump. Physical findings on examination included a well-defined, smooth, near-spherical tumor (diameter, 4cm) that was palpable around the left areolar region. The axillary lymph nodes were not palpable. Needle biopsy indicated a class III papillary lesion that was diagnosed as a possible case of intraductal papilloma. A left mastectomy was performed in April 2007. Histopathological examination showed that the proliferative cells were negative for CK5/6, p63, CD10, CK14, and SMA. In addition, the cells were negative for SYN, CGA, and CD56, while diffuse positive staining was observed for ER and positive nuclear staining was sporadically observed for S-100P in very few cells. Cells positive for 34βE12 were observed in a mosaic-like pattern within the tumor, while an increased proliferative activity was observed on MIB1 staining. Based on these findings, the patient was diagnosed with non-invasive, ductal carcinoma of male breast. Male breast cancer is a rare condition, particularly in its non-invasive form. We report the present case with reference to literature.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 69(7), 1606-1610, 2008-07-25
Japan Surgical Association