AIM:To investigate the clinicopathological characteristics, differential diagnoses, and prognostic implications of uterine metastasis originating from lung adenocarcinoma. METHODS:A retrospective clinicopathological analysis was performed on five cases of lung adenocarcinoma with uterine metastasis, supplemented by a literature review. RESULTS:Patients' ages ranged from 33 to 66 years (mean: 52.80±12.56 years). All patients were histologically confirmed to have lung adenocarcinoma. The metastatic sites included the uterine corpus (three cases), cervical leiomyoma (one case), and cervical endometrium (one case). Serum levels of carcinoembryonic antigen were elevated in three patients, and one patient exhibited a high-grade squamous intraepithelial lesion on the ThinPrep cytologic test. The predominant clinical presentations were abnormal vaginal bleeding (3/5 cases) or abdominal pain and bloating (1/5 cases), with one asymptomatic patient whose metastasis was incidentally discovered. Histologically, the tumors displayed glandular, nested, or solid growth patterns with focal degeneration, abundant eosinophilic or clear cytoplasm, and nuclear atypia. Immunohistochemically, the tumor cells were positive for thyroid transcription factor-1 (TTF-1), Napsin A, and cytokeratin 7 (CK7) in all cases, while negative for estrogen receptor (ER), progesterone receptor (PR), paired-box gene 8 (PAX-8), and p16. CONCLUSION:Lung cancer metastasizing to the uterus is exceedingly rare and is associated with non-specific clinical and morphological features. Immunohistochemical markers, particularly TTF-1, Napsin A, and CK7 positivity, combined with ER, PR, PAX-8, and p16 negativity, could help distinguish metastatic lung adenocarcinoma from primary uterine malignancies.

Background: To evaluate the prognostic impact of the molecular classification of grade 3 endometrioid endometrial carcinoma (G3-EEC) and its correlation with clinicopathological factors. Methods: 137 patients with G3-EEC were enrolled and molecularly classified using Sanger sequencing in exons 9-14 of the polymerase epsilon (POLE) gene and immunohistochemistry (IHC) staining for p53, MLH1 (mutL homolog 1), PMS2 (PMS1 homolog 2), MSH2 (mutS homolog 2) and MSH6 (mutS homolog 6). The Kaplan-Meier method and Cox regression were used for survival analysis, and the chi-square and Fisher's exact tests were used for comparisons between categorical data. Results: POLE hotspot mutations (POLEmut group) were identified in seven tumors (5.1%); 46 (33.6%) tumors showed deficient mismatch repair (dMMR group); 22 (16.1%) showed abnormal p53 staining (p53abn group); and 58 (42.3%) were classified as nonspecific molecular profiles (NSMP group). The remaining four patients (2.9%) were grouped as multi-classifiers. The median follow-up was 45.2 months (range: 6-128 months), with an overall survival (OS) rate of 84.6% (116/137) and a progression-free survival (PFS) rate of 81.7% (112/137). There was no significant difference in the molecular subgroups with OS and PFS (p = 0.05 and p = 0.162, respectively). The prognosis was most favorable in the POLEmut, intermediate in the dMMR and NSMP, worst in the p53abn group, and unclear in the multi-classifier group. Multivariate analysis showed that the International Federation of Gynecology and Obstetrics (FIGO) stage (FIGO 2009 and FIGO 2023) and lymphovascular space invasion were significant independent prognostic factors in OS and PFS (p < 0.05). Myometrial invasion, bizarre atypia, and peritumoral lymphocytes showed significant differences among the molecular groups (p = 0.026, p < 0.001 and p = 0.001, respectively). Conclusions: Our study demonstrated the prognostic value of the molecular classification of G3-EEC. The biological behavior of the multi-classifier group remains undefined.

Traditional classification methods for cervical cells heavily rely on manual feature extraction, constraining their versatility due to the intricacies of cytology images. Although deep learning approaches offer remarkable potential, they often sacrifice domain-specific knowledge, particularly the morphological patterns characterizing various cell subtypes during automated feature extraction. To bridge this gap, we introduce a novel hierarchical framework that integrates robust features from color, texture, and morphology with latent representations discovered by an improved attention-based multi-scale local binary convolutional neural networks (MS-LBCNN), designed to facilitate powerful feature extraction mechanism. We enhance the standard 6-class Bethesda system (TBS) classification by incorporating a coarse-to-refine fusion strategy, which optimizes the classification process. The proposed method is uniquely equipped to manage the complexities present in both individual and clustered cell images. Upon rigorous evaluation across three independent data cohorts, our method consistently surpassed existing state-of-the-art techniques. The experimental results indicated the potential of our method in enhancing the development of automation-aided diagnostic systems, and bolstering both the accuracy and efficiency of cytology screening procedures.

Purpose: Platinum-based chemotherapy is effective but limited by resistance in high-grade serous ovarian cancer (HGSOC). Single-cell RNA sequencing (scRNA-seq) can reveal tumour cell heterogeneity and subclonal differentiation. We aimed to analyze resistance mechanisms and potential targets in HGSOC using scRNA-seq. Methods: We performed 10× genomics scRNA-seq sequencing on tumour tissues from 3 platinum-sensitive and 3 platinum-resistant HGSOC patients. We analyzed cell subcluster communication networks and spatial distribution using cellchat. We performed RNA-seq analysis on TACSTD2, a representative resistance gene in the E0 subcluster, to explore its molecular mechanism. Results: Epithelial cells, characterized by distinct chemotherapy resistance traits and highest gene copy number variations, revealed a specific cisplatin-resistant cluster (E0) associated with poor prognosis. E0 exhibited malignant features related to resistance, fostering growth through communication with fibroblasts and endothelial cells. Spatially, E0 promoted fibroblasts to protect tumour cells and impede immune cells infiltration. Furthermore, TACSTD2 was identified as a representative gene of the E0 subcluster, elucidating its role in platinum resistance through the Rap1/PI3K/AKT pathway. Conclusions: Our study reveals a platinum-resistant epithelial cell subcluster E0 and its association with TACSTD2 in HGSOC, uncovers new insights and evidence for the platinum resistance mechanism, and provides new ideas and targets for the development of therapeutic strategies against TACSTD2+ epithelial cancer cells.

目的:探讨非典型宫颈管腺细胞（atypical endocervical cells，AEC）的临床病理学特征。方法:收集首都医科大学附属北京妇产医院2021年3月至2023年12月宫颈液基细胞学判读为AEC病例的人乳头瘤病毒（humanpapilloma virus，HPV）、组织学等资料并分析。结果:AEC共123例，检出率为0.09%（123/131 966），包括98例非典型宫颈管腺细胞-非特异（AEC，nototherwise specified，AEC-NOS）和25例非典型宫颈管腺细胞-倾向于肿瘤（AEC，favor neoplastic，AEC-FN）。AEC-NOS及AEC-FN病例HPV阳性率分别为35.6%、65.2%。AEC-NOS病例中73例有组织学随访结果，13例为高级别上皮病变，包括2例子宫内膜非典型增生、7例宫颈HPV相关性腺癌及原位腺癌、4例宫颈高级别鳞状上皮内病变（HSIL）及鳞状细胞癌。AEC-FN病例中20例有组织学结果，16例组织学为高级别上皮病变，包括2例子宫内膜腺癌、8例宫颈HPV相关性原位腺癌及腺癌、1例宫颈胃型腺癌、5例宫颈HSIL及鳞状细胞癌；2例活检病理为良性的AEC-FN病例，复阅细胞涂片后，细胞学仍高度提示存在宫颈高级别腺上皮病变。结论:AEC提示宫颈癌及癌前病变风险性增高，尤其是宫颈腺癌及原位腺癌；HPV阴性的AEC病例出现宫颈癌及癌前病变的风险性明显较HPV阳性者低；对于AEC-FN病例，无论是否感染HPV、无论初次活检结果如何，都要引起高度重视。

乳腺产生基质的癌(MPC)是一种少见的乳腺化生性癌组织学亚型,新版乳腺肿瘤WHO分类仅有小篇幅描述,国内外文献多为个案或小样本报道.MPC具有独特的形态学特征和免疫表型,但文献报道对预后颇有争议.在此着重就MPC的临床病理特征、免疫表型、诊断及鉴别诊断及预后方面研究进展作一概述.

Traditional classification methods often involve the extraction of multiple handcrafted features from cervical cells, resulting in low versatility due to the complexity of cytology images. Moreover, in deep learning approaches, domain knowledge of cervical cells, especially morphological patterns of different subtypes, will be lost during automated feature extraction. To address these limitations, this work proposes a new cascade learning framework that fuses strong features from color, texture, and morphology withabstract features from the hidden layers of an efficient deep learning model, effectively improving the accuracy of cell recognition. A light-weight attention based local binary convolutional neural network (LBCNet) is constructed to build a cascaded learning algorithm. The model enables to flexibly handlesingle and cluster cell images. A 6-class TBS classification is further boosted through a newly-derived coarse-to-fine fusion strategy. The method was extensively evaluated on three independent data cohorts, and outperformed the state-of-the-art approaches with an accuracy of 0.985. Experiments indicate that our method is promising for the development of automation-assisted diagnosing system to improve cytology screening test.

We aimed to develop an artificial intelligence (AI) diagnosis system for uterine smooth muscle tumors (UMTs) by using deep learning. We analyzed the morphological features of UMTs on whole-slide images (233, 108, and 30 digital slides of leiomyosarcomas, leiomyomas, and smooth muscle tumors of uncertain malignant potential stained with hematoxylin and eosin, respectively). Aperio ImageScope software randomly selected ≥10 areas of the total field of view. Pathologists randomly selected a marked region in each section that was no smaller than the total area of 10 high-power fields in which necrotic, vascular, collagenous, and mitotic areas were labeled. We constructed an automatic identification algorithm for cytological atypia and necrosis by using ResNet and constructed an automatic detection algorithm for mitosis by using YOLOv5. A logical evaluation algorithm was then designed to obtain an automatic UMT diagnostic aid that can "study and synthesize" a pathologist's experience. The precision, recall, and F1 index reached more than 0.920. The detection network could accurately detect the mitoses (0.913 precision, 0.893 recall). For the prediction ability, the AI system had a precision of 0.90. An AI-assisted system for diagnosing UMTs in routine practice scenarios is feasible and can improve the accuracy and efficiency of diagnosis.

目的 探讨子宫颈胃型腺癌(gastric-type cervical adenocarcinoma,GCA)的临床病理特征、诊断及鉴别诊断.方法 收集35 例GCA的临床病理资料,采用免疫组化EnVision两步法检测GCA石蜡组织中p53、p16、PAX2、HIK1083、MUC6 等的表达,应用AB-PAS特殊染色检测其黏液性质,分析GCA的临床病理特征并复习相关文献.结果 35 例患者年龄 28～75 岁,平均51.1 岁;临床表现最常见为异常子宫出血及阴道排液,部分病例肿瘤标志物CA19-9 升高(15/24,62.5％);大部分病例FIGO分期处于进展期(Ⅱ～Ⅳ期).免疫表型:p53 突变型患者FIGO分期高于野生型患者(P＜0.05);HIK1083(13/24,54.2％)、MUC6(27/30,90.0％)在部分GCA中呈阳性,PAX2 均阴性.AB-PAS特殊染色示黏液均红染.结论 GCA组织学复杂多样,根据组织学特征并联合应用AB-PAS特殊染色及免疫组化染色可进行准确诊断.

Aim: To ascertain the clinicopathological features, survival, and prognostic factors of pure uterine serous carcinoma (pUSC) and compare its clinicopathological characteristics with those of serous-like grade-3 endometrioid endometrial carcinoma (G3-EEC).Method: Consecutive patients with pUSC and p53 abnormal (p53abn) G3-EEC were retrospectively selected between 2014 and 2022. Histological and immunohistochemical features were reviewed, clinical information was collected, and survival analyses were performed.Results: Eighty-five pUSC patients (mean age: 61.6 years) were included. Histologically, pUSC showed a predominantly glandular growth pattern (80.0 %) with high-grade nuclear atypia and obvious nucleoli and 53 cases showed admixtures of architectural patterns. The p53 aberrant expression rate was 98.8 %. 41.5 %, 53.7 %, and 67.5 % of cases were classified as negative for ER, PR, and WT1, respectively. Six (12.3 %) of 49 cases had a HER2 score of 3+ by immunohistochemistry (IHC). The overall survival and progression-free survival rates were 72.9 % and 63.5 %, respectively. Advanced stage, no adjuvant therapy, and lymph node metastasis were independent risk factors for poor survival in pUSC. Twenty-five p53abn G3-EEC patients were assessed. Women with p53abn G3-EEC were on average, younger than those with pUSC (53.4 vs. 61.6 years, P < 0.001). Papillary structures were observed more commonly in pUSC (16 % vs. 36.5 %, P = 0.042). Positive PR expression was significantly associated with p53abn G3-EEC (P = 0.009). Survival did not differ significantly between the subgroups in univariate and multivariate analyses.Conclusion: In this contemporary series, we affirm the suboptimal prognosis associated with pUSC, and that the survival associated with pUSC and p53abn G3-EEC are not significantly different. pUSC and p53abn G3-EEC have distinct morphological and immunohistochemical characteristics.

中肾样腺癌是新近发现的一种罕见的女性生殖系统恶性肿瘤。由于中肾样腺癌生长方式的多样性，与许多肿瘤存在不同程度的组织学重叠，使得其诊断极具挑战性。基于GATA3、甲状腺转录因子1（TTF1）、CD10等免疫组织化学标志物的联合应用，减少了此类肿瘤的漏诊和误诊。与中肾腺癌100%具有KRAS突变相似，>80%的中肾样腺癌存在该基因的高频突变。但是与中肾腺癌鲜少出现PIK3CA、PTEN、CTNNB1等基因突变不同，KRAS突变的部分中肾样腺癌同时也可以检测到这些与苗勒源性肿瘤相关的重要分子改变。此外，中肾样腺癌还具有中等水平的基因组不稳定性。有趣的是，中肾样腺癌与苗勒源性病变混合存在的病例中，二者不仅具有相同KRAS/NRAS突变及拷贝数异常，各自还有其独特的分子改变。中肾样腺癌常与苗勒源性病变合并存在，结合分子遗传学改变，佐证了中肾样腺癌的起源可能与苗勒管密切相关。目前，中肾样腺癌尚无标准的治疗方案，临床仍以经验性手术±放/化疗的治疗模式为主，疗效尚不确切。鉴于KRAS基因在中肾样腺癌的高频突变，靶向KRAS通路相关基因及KRAS突变的合成致死搭档的药物开发有望为这类患者的治疗迎来曙光。

目的 探讨腹膜细胞学阳性与高级别子宫内膜样癌各临床病理参数的关系及其预后价值.方法 选取2010年1月至2020年12月在首都医科大学附属北京妇产医院诊断为高级别子宫内膜样癌、接受分期手术并进行腹膜细胞学检查的患者131例,收集其临床病理资料并进行随访分析.结果 131例高级别子宫内膜样癌患者中25例(19.1％)腹膜细胞学检查阳性.腹膜细胞学阳性与国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)分期、风险分层、宫颈间质浸润、肌层浸润深度、附件受累、淋巴结转移及孕激素受体表达有关(P＜0.05),而与年龄、脉管癌栓、雌激素受体(estrogen receptor,ER)表达、p53表达及错配修复蛋白(mismatch repair,MMR)表达无关(P＞0.05).单因素生存分析显示FIGO分期、风险分层、宫颈间质浸润、肌层浸润、脉管癌栓、附件受累、淋巴结转移与总生存期及无进展生存期均显著相关(P＜0.05),腹膜细胞学阳性患者的无进展生存期低于阴性患者(P=0.043),但总生存期二者差异无显著性(P=0.052).多因素生存分析显示,FIGOⅢ期及Ⅳ期[HR(95％CI)分别为2.649(0.273～25.695)、2.919(1.903～4.480),P=0.000]、疾病进展[HR(95％CI):67.003(14.786～303.630),P=0.000]、p53表达[HR(95％CI):0.034(0.134～0.878),P=0.026]以及ER表达[HR(95％CI):3.068(1.222～7.700),P=0.017]为影响患者总生存期的独立危险因素;高危组及进展转移组[HR(95％CI)分别为2.134(0.890～4.734)、2.969(1.720～5.124),P=0.000]、脉管癌栓[HR(95％CI):3.853(1.128～13.164),P=0.031]、p53表达[HR(95％CI):0.297(0.134～0.878),P=0.011]为影响患者无进展生存期的独立危险因素.结论 尽管腹膜细胞学阳性并非影响高级别子宫内膜样癌患者预后的独立危险因素,但腹膜细胞学阳性患者仍显示出更短的无进展生存期,且与侵袭性因素相关,因此需关注高级别子宫内膜样癌患者的腹膜细胞学检查结果.

细胞DNA定量分析系统对于宫颈癌早期诊断及癌前病变评估具有有效的诊断意义及临床应用价值[1-2].Feulgen染色法是DNA定量检测的标准方法[3].由于Schiff试剂的质量和配制条件等是Feulgen反应成功与否的关键因素,田玉旺等[4]采用硫堇试剂替换Schiff试剂对细胞核DNA进行染色获得了良好的染色效果.为进一步提升Feulgen-硫堇染色的质量,本实验通过探讨硫堇试剂的配制温度对DNA定量分析染色效果的影响,提高细胞学诊断的敏感性和特异性.

原发性子宫内膜鳞状细胞癌（primary endometrial squamous cell carcinomas，PESCC）是一种罕见的子宫内膜癌。本文报道1例55岁患者，刮宫标本及经腹腔镜筋膜外全子宫切除标本组织学形态均显示不同分化程度的鳞状上皮呈浸润性生长，并见短梭形细胞，胞质丰富、透亮。刮宫标本中未见正常子宫内膜腺体及异常腺性结构；全子宫切除标本中短梭形与鳞状上皮穿插生长，侵犯浅肌层，周围子宫内膜可见慢性子宫内膜炎，局灶符合子宫内膜不典型增生；免疫表型：明确的鳞状上皮成分及短梭形细胞广谱细胞角蛋白、细胞角蛋白（CK）5/6、p63、β-catenin、CD10均阳性，CK7、CDX2阴性。患者随访8个月，身体状况良好。PESCC需要严格掌握诊断标准，除外子宫颈来源的鳞状细胞癌及子宫内膜样癌伴广泛鳞化。该文描述PESCC组织学特点、刮宫及全子宫标本诊断难点、阐述其诊断要点，并复习和总结相关文献。

目的:探讨以浸润模式为基础的新的风险分层体系在宫颈HPV相关性腺癌中的应用及临床意义.方法:收集首都医科大学附属北京妇产医院2016年6月至2019年11月诊断的宫颈腺癌病例.经过筛选,共入组54例HPV相关性腺癌.采用以Silva分型为基础的新的风险分层体系,将54例HPV相关性腺癌分为Pattern A、Pattern B和Pattern C三种亚型,并分析各亚型的临床病理特征.结果:在54例宫颈HPV相关性腺癌中,Pattern A 17例(31.5％),Pattern B 10例(18.5％),Pattern C 27例(50.0％).17例Pattern A均为I期,所有病例未见淋巴管脉管间隙浸润(lymphatic vascular space invasion,LVSI)及淋巴结转移,10例Pattern B均为I期,1例可见LVSI,所有病例未见淋巴结转移.27例Pattern C包括I期15例、II期6例、III期6例,10例(37.0％)可见LVSI,6例伴有淋巴结转移.54例HPVA患者的FIGO分期与各Pattern分型的差异具有统计学意义(χ2=15.172,P<0.001).在浸润深度方面,Pattern A和Pattern C的差异有统计学意义(χ2=9.279,P=0.005).在LVSI方面,Pattern A和Pattern C的差异有统计学意义(χ2=17.443,P<0.001).在淋巴结转移率方面,Pattern A和Pattern C的差异有统计学意义(χ2=10.004,P=0.002).结论:以浸润模式为基础的新的风险分层体系应用到HPVA的病理诊断中,提高了早期HPVA诊断的一致性,可以很好地分流早期HPVA患者.Pattern A很少有淋巴结转移,可以采取更加保守的治疗,免于盆腔淋巴结清扫术,提高生活质量.Pattern C需要采取更加积极的治疗.Pattern B的治疗选择还需更进一步的研究.与FIGO分期相比,以浸润模式为基础的新的风险分层体系,能够更加个体化地指导HPV,尤其是Pattern A相关性腺癌患者的治疗.

BACKGROUND Low-grade endometrial stromal sarcoma (LGESS) classically exhibits a proliferative morphology. However, morphological variation of extrauterine tumors presents a diagnostic challenge. CASE SUMMARY We report the case of a 76-year-old female patient with extensive extrauterine and abdominal neoplastic lesions. Computed tomography showed massive pleural and ascitic fluid, and there was an increase in serum cancer antigen 125. She underwent bilateral adnexectomy and tumor resection. The right ovary had been replaced by a multinodular mass that was 8.5 cm × 4.5 cm × 3.5 cm in size. In addition, there was a 24 cm × 15 cm × 13 cm mesenteric mass, which was also multinodular, with local invasion of the intestinal serosa and underlying muscle. Under the microscope, the tumors in different places exhibited two different patterns, thus presenting great challenges to diagnosis and treatment. Thorough pathological assessment eliminated all differential diagnoses in favor of metastatic LGESS derived from a 20-year-old primary tumor initially misdiagnosed as leiomyosarcoma. CONCLUSION LGESS morphology varies according to tumor location. Accurate diagnosis is critical for appropriate treatment and improved prognosis and patient care.

目的 探讨胰岛素样生长因子2 mRNA结合蛋白3(insulin like growth factor 2 mRNA binding protein 3,IMP3)在卵巢高级别浆液性癌(high grade serous carcinoma,HGSC)及子宫浆液性癌(uterus serous carcinoma,USC)中的表达及意义.方法 选取2017年1月至2020年12月经首都医科大学附属北京妇产医院病理科明确诊断的卵巢HGSC及USC患者各43例,收集患者临床资料并观察组织学特点,采用免疫组化染色检测癌组织中IMP3、ER、PR、p53、p16、WT1等的表达情况,分析免疫表达与临床病理特征的相关性以及IMP3对两种浆液性癌起源部位的鉴别意义及预后评估价值.结果 卵巢HGSC及USC组患者具有相似的浆液性癌的组织病理学特点,但在发病年龄、网膜/腹膜是否累及、腹腔冲洗液/腹水细胞学检查阳性、国际妇产科联盟(The International Federation of Gynecology and Obstetrics,FIGO)分期以及IMP3、ER、PR、p16、WT1抗体表达方面差异均有显著性(P<0.05),而在淋巴结转移及p53表达方面差异无显著性(P>0.05).与卵巢HGSC组相比,USC组患者发病年龄更大但分期较早,不易累及网膜/腹膜和出现腹腔冲洗液/腹水细胞学检查阳性,IMP3、p16阳性率更高,而ER、PR及WT1阳性率更低,差异均有显著性(P<0.05).IMP3表达与两组发病年龄、淋巴结转移、累及网膜/腹膜、腹腔冲洗液/腹水细胞学检查阳性、FIGO分期等临床病理参数以及ER、PR、p53、p16、WT1抗体表达均无关(P>0.05).结论 IMP3表达对鉴别浆液性癌的起源部位具有一定诊断价值,对卵巢HGSC及USC的预后价值尚不明确.

We report on a 50-year-old postmenopausal woman who presented with abnormal uterine bleeding and pelvic pain due to a uterine solid mass grew from the uterine fundus to the cervix and with so far undescribed obviously gelatinous grossly change, which was suspected of myxoid leiomyosarcoma in intraoperative diagnosis. Morphologically, the tumor cells displayed haphazard fascicles of uniform mild-to-moderate heteromorphic spindle cell component with significant and abundant myxoid stroma, forming signet ring cells and microcysts. Immunohistochemically, the tumour cells were diffusely positivefor CD10 and cyclin D1 and negative for Desmin and SMA, but the expression of BCOR staining was not present. The FISH study showed a positive BCOR gene break probe, and the RNA sequencing revealed an identified reciprocal fusion gene ZC3H7B-BCOR. The case was finally diagnosed as ZC3H7B-BCOR high-grade endometrial stromal sarcoma. Tumor recurrence occurred rapidly on the pelvic peritoneal and vaginal 2 months after resection. In conclusion, these findings further support ZC3H7B-BCOR HGESS has a poor prognosis and molecular testing of uterine mesenchymal tumors with myxoid matrix and unusual grossly presentation is recommended to avoid misdiagnosis.

Inflammatory myofibroblastic tumor (IMT) is a mesenchymal spindle cell tumour with low malignant potential which is extremely rare in breasts. Because of the lack of typical imaging and clinical characteristics of IMT, it is easy to misdiagnose before operation. We now report a case of a 37-year-old woman presenting with a mass in her left breast. Ultrasound showed a well-circumscribed lesion in the lower outer quadrant. The patient underwent lumpectomy, and histopathology revealed a tumor which was composed of fusiform cells and inflammatory cells. Immunohistochemistry (IHC) showed tumor cells are positive for vimentin, ALK, BCL2, and SMA. The FISH test demonstrated ALK (2p23) chromosomal translocation (ALK positive). The final diagnosis of breast IMT was rendered with nonclassical morphology. Postoperative 30-month follow-up no evidence showed residual tumor or recurrence. As a very rare tumor, breast IMT could be easily misdiagnosed clinically and pathologically. Complete surgical resection of the tumor is preferred, and it has the risk of recurrence and metastasis.

乳腺分泌基质的癌(matrix-producing carcinoma,MPC)是乳腺化生性癌(metaplastic breast carcinoma,MBC)中较为罕见的组织学亚型,约占乳腺浸润性癌0.1％[1].笔者报道1例多次复发的多结节状完全型MPC,现结合文献报告如下,以期提高临床医师对MPC的认识,特别是完全型MPC,避免误诊、误治.