乳腺包裹性乳头状癌讨论病例【中美加乳腺病理交流群病例43】

小王

孔祥田
64 yo F left breast axillary tail 1.4 cm mass, core bx. Breast triple and CK5/6 done. How do you report?

Bill,Emory
papillary CA

镇江四院病理科许跃
支持EPC

景晓峰
@孔祥田(Max)*Sacramento*CA] ，我和@镇江四院病理科许跃 老师的看法一致。

李国霞 上海
鉴别导管内乳头状癌 还是EPC的问题。这个三染色不太会看，囊壁到底p63染色是阴性还是阳性呀

陈东
至少EPC

李国霞 上海



杨鹏
癌。

一汽总医院病理科佟
包裹性乳头癌

251医院黄勇
EPC基础上papillary CA

杨鹏
乳头状癌。@孔祥田(Max)*Sacramento*CA] 考虑转移吗。

孔祥田
This is H&E slide. Red dye is inked. @李国霞上海 
@杨鹏 淄博市妇幼保健院 群管 no
P63 and calponin are negative. Cam5.2 positive. Ck5/6 negative @李国霞上海 

李国霞 上海
是乳头状癌，问题是活检肯定有浸润吗？是EPC还是浸润性乳头状癌

孔祥田
Here is My Dx: Papillary carcinoma. See comment: The ddx includes encapsulated papillary carcinoma(EPC) and papillary DCIS. CK5/6 negative supporting atypical features and ruling out the possibility of papilloma. Negative for myoepithelial markers(p63 and calponin) supporting the above Dx. Due to sampling issue, papillary DCIS is still in the ddx. Further subclassification of the lesion is dependent on complete excision. By the way, EPC is still considered as DCIS. SPC is not in the ddx by morphology.One month later, my colleague got the lumpectomy.



















Follow up lumpectomy: 64 yo F left breast/axillary tail lumpectomy. The cystic lesion measures 1.8 cm. The invasive focus measures 2 mm. Margins are negative. One sentinel lymph node negative for carcinoma. How do you report the case now?

李国霞 上海
看到浸润性癌，成分少一点，EPC+invasive ductual carcinoma，说明各大小。说明：还有淋巴结阴性。应该反过来说，先报浸润性导管癌，大小2mm，伴EPC，大小1.8cm，前哨淋巴结阴性。额，活检容易低诊断为EPC。学习了，很好的病例。谢谢！

孔祥田
Final Dx: Invasive ductal carcinoma (2 mm) associated with encapsulated papillary carcinoma(EPC, 18 mm). EPC is still considered as DCIS nowadays. The word intracystic is not used by WHO now.

阳光56

包裹性乳头癌