摘要
目的:肉芽肿小叶性乳腺炎患者多伴发乳腺导管扩张症且导管内含大量油脂样分泌物。本研究以HE染色、免疫组织化学染色及免疫荧光染色为途径探讨肉芽肿小叶性患者乳腺导管的病理学特征,并为其病因学及临床治疗提供线索。方法:对东直门医院病理诊断为肉芽肿小叶性乳腺炎的28例患者的未扩张导管、扩张导管、病变小叶及肉芽肿灶进行HE染色及表皮生长因子样结构含黏蛋白激素样受体1(epidermal growth factor-like modulecontaining mucin-like hormone receptor-like 1,F4/80)、淋巴细胞分化簇(cluster of differentiation,CD)11c的免疫组织化学和免疫荧光染色,分析其病理学特征并进行巨噬细胞计数。结果:免疫组织化学染色示:扩张大导管及小叶周围可见CD11c阳性的巨噬细胞聚集性表达,被完全破坏乳腺小叶结构的肉芽肿及未扩张的导管周围表达不明显。扩张大导管、被完全破坏乳腺小叶结构的肉芽肿、未完全破坏乳腺小叶结构的肉芽肿可见F4/80阳性的巨噬细胞聚集性表达,未扩张的导管周围表达不明显。免疫荧光染色示:F4/80、CD11c共标志阳性的细胞在扩张导管、病变小叶周围聚集性表达,在无扩张的导管及肉芽肿病灶周围无表达。结论:肉芽肿小叶性乳腺炎的发病机制可能为乳腺导管巨噬细胞的吞噬功能障碍激发的IV型变态反应。
Objective:Patients with granulomatous lobular mastitis often exhibit concurrent ductal dilation in the breast with the presence of abundant lipid-like secretions with ducts.This study aims to investigate the pathological characteristics of breast ducts in patients with granulomatous lobular mastitis using hematoxylin and eosin(HE)staining,immunohistochemistry staining,and immunofluorescence staining.The findings provide insights into the pathogenesis and clinical treatment of granulomatous lobular mastitis.Methods:HE staining,immunohistochemistry for epidermal growth factor-like module containing mucin-like hormone receptor-like 1(F 4/80),and cluster of differentiation(CD)11 c,as well as immunofluorescence staining were performed on sections of non-dilated ducts,dilated ducts,lesional lobules,and granulomatous foci from 28 patients diagnosed with granulomatous lobular mastitis at Dongzhimen Hospital of Beijing University of Chinese Medicine.Pathological features were analyzed,and macrophage counts were performed.Results:Immunohistochemical staining showed that CD 11 c-positive macrophages were clustered around dilated ducts and adjacent to affected lobules.However,their expression was less prominent around non-dilated ducts and granulomatous lesions with complete destruction of lobular structures,and granulomatous lesions with incomplete destruction of lobular structures,but their expression was less evident around non-dilated ducts.Immunofluorescence staining showed cells co-expressing F 4/80 and CD 11 c in clusters around dilated ducts and affected lobules,while no expression was observed around non dilated ducts and granulomatous foci.Conclusion:The pathogenesis of granulomatous lobular mastitis may involve a type IV hypersensitivity reaction triggered by impaired phagocytic function of macrophages within breast ducts.
作者
左禧萌
高翔
汪唐顺
高爽
史晓光
ZUO Ximeng;GAO Xiang;WANG Tangshun;GAO Shuang;SHI Xiaoguang(Department of General Surgery,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《临床与病理杂志》
2023年第10期1786-1792,共7页
Journal of Clinical and Pathological Research
基金
北京中医药大学新教师创新项目(2021-BUCMXJKY001)。
