Myoepithelial changes in breast apocrine lesions: report of two cases
WU Huan-wen
LIU Xu-guang
TENG Liang-hong
LI Jun-jie
WANG Jing
ZHANG Hui
PANG Jun-yi
LIANG Zhi-yong
Abstract：Objective Two cases of apocrine papillary lesions were presented together with a literature review to explore the alterations in myoepithelial cells in breast apocrine lesions.Methods Two cases of apocrine papillary lesions of the breast were studied by histopathological examination and immunohistochemical staining with a review of the literature.Results Case 1:a 70-year-old woman presented with a left breast mass for 1 week.Gross examination revealed an cystic and solid nodule measuring 0.9 cm in diameter,which histologically showed well-encapsulated sclerosing papillary lesions with extensive apocrine metaplasia.In the areas of apocrine metaplasia,myoepithelial cells were not identified either on hematoxylin and eosin-stained slides or by p63 and CD10 immunostaining,whereas SMA,CK14 and CK5/6 immunostaining all revealed a continuous myoepithelial cell layer both in the central papillary cores and at the periphery.Case 2:a 60-year-old woman presented with a left breast mass for 6 months.On gross examination,a friable mass within a well-encapsulated cyst measuring 4.5 cm in diameter was revealed.On histological examination,the lesion was surrounded by a thick fibrous capsule,and composed of neoplastic epithelial cells with intermediate-grade nuclei.The tumor cells were arranged in cribriform and papillary patterns with delicate fibrovascular stalks and prominent apocrine features.Focal necrosis and calcification were also observed.Myoepithelial cells were not visualized in the central papillary cores or at the periphery of the cystic wall either on hematoxylin and eosin-stained slides or by p63,CD10,calponin,CK5/6,SMA,S100 and CK14 immunostaining.Sentinel lymph node biopsy revealed no metastasis.The final diagnoses were sclerosing intraductal papilloma with atypical apocrine hyperplasia and encapsulated apocrine papillary carcinoma,respectively.Conclusion Phenotypic alterations,diminished number or complete loss of myoepithelial cells may be found in benign apocrine lesions,and neither p63 or CD10 is an optimal marker for the myoepithelial cells in apocrine lesions.A malignant diagnosis of apocrine papillary lesions should be based on the usage of multiple myoepithelial cell markers together with the overall cytologic and architectural features.
Keywords：Breast apocrine lesionsMyoepitheliumPathologic diagnosisImmunophenotype
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 165-169 )