Clinical pathological observation on differentiation of breast tissue sarcoma

Objective To investigate the clinical and pathological breast sarcoma histological features,immune phenotype relationship with histological origin.Methods Three cases of breast sarcoma clinical and pathological data were retrospectively analyzed by immunohistochemical markers and review of the literature discussion.Results Three cases occurred in middle-aged women,aged 36-91 years with a duration of 10 days to 20 years,unilateral upper outer quadrant of the breast more common,can be accompanied by skin ulceration and ipsilateral axillary lymph nodes.B-ultrasound often prompted mass echo uneven distribution of boundary less clear,not structured,rich blood flow.X-ray mammography BI-RADS high level.Macroscopic tumor boundary less clear,cut gray matter in more rigid.Microscopic changes:the tumor cells from oval epithelioid and spindle cells,accompanied by squamous epithelium,smooth muscle,cartilage and bone tissue differentiation.Epithelial cells showed solid nests regiment,accompanied comedo necrosis,the shape of the structure of invasive ductal carcinoma.Spindle cells arranged in diffuse,atypia,the shape of sarcoma-like structure.Immunohistochemical results:among 3 cases,2 cases of cancer ingredients were expressed with CK,E-cad,CK(H) and EMA,sarcoma component expressed Vimentin,SMA,S-100 and EMA; 1 cancerous and sarcomatous components were expressed CK and Vimentin,sarcoma component expressed CD34.Conclusion Breast sarcoma is not only an expression of epithelial antibodies but also an expressed nonepithelial antibodies epithelial/mesenchymal mixed metaplastic carcinoma.The occurrence of ductal epithelial tumor related,some lesions may be related with muscle metaplasia.Immunohistochemical detection of relevant antibodies,may indicate the source of tumor components. Key words: Breast cancer;  Metaplastic carcinoma;  Carcinosarcoma;  Immunohistochemistry