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中华乳腺病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (05) : 322 -325. doi: 10.3877/cma.j.issn.1674-0807.2022.05.011

病例报告

男性乳房发育症伴乳腺假血管瘤样间质增生一例
姚成才1,(), 刘长春1, 陈健智2   
  1. 1. 528225 佛山,华南理工大学附属第六医院乳腺外科
    2. 528225 佛山,华南理工大学附属第六医院病理科
  • 收稿日期:2022-02-18 出版日期:2022-10-01
  • 通信作者: 姚成才
  • 基金资助:
    佛山市高层次医学人才培养基金(2018B015)

Gynecomastia associated with pseudoangiomatous stromal hyperplasia: one case report

Chengcai Yao1(), Changchun Liu1, Jianzhi Chen2   

  • Received:2022-02-18 Published:2022-10-01
  • Corresponding author: Chengcai Yao
引用本文:

姚成才, 刘长春, 陈健智. 男性乳房发育症伴乳腺假血管瘤样间质增生一例[J]. 中华乳腺病杂志(电子版), 2022, 16(05): 322-325.

Chengcai Yao, Changchun Liu, Jianzhi Chen. Gynecomastia associated with pseudoangiomatous stromal hyperplasia: one case report[J]. Chinese Journal of Breast Disease(Electronic Edition), 2022, 16(05): 322-325.

乳腺假血管瘤样间质增生(pseudoangiomatous stromal hyperplasia,PASH)是一种乳腺良性疾病,单纯性PASH临床少见,但常与其他乳腺病变共存而偶然被诊断。文献报道超过23%的乳房活组织检查和切除标本中会发现PASH[1],而这一疾病在男性乳房发育症(gynecomastia,GYN)患者中的发生率可能高达25%[2,3]。国内外文献中关于此类疾病的报道较少,而且多为个案[4,5]。近期笔者诊治了1例GYN伴PASH的患者,现报道如下。

图1 男性右侧乳房发育症伴假血管瘤样间质增生患者术前乳房外观 注:胸部不对称,右侧乳房肥大呈女性化改变
图2 男性右侧乳房发育症伴假血管瘤样间质增生患者术前乳房彩色超声图 a图所示右侧乳晕下可探及腺体样组织,厚约7 mm,内部回声低,欠均匀,腺体样组织内未见明显实性及囊性肿块;b图所示左侧胸壁乳头下方未见腺体组织
图3 男性右侧乳房发育症伴假血管瘤样间质增生患者接受全腔镜肥大乳房矫形术 a图所示术前体表标记;b图所示腔镜手术术中操作;c图所示腋窝切口及切除的腺体组织
图4 男性右侧乳房发育症伴假血管瘤样间质增生患者乳腺组织术后病理图(HE ×200)。 注:乳腺导管周围间质增生,形成裂隙样结构,细胞无异型性
图5 男性右侧乳房发育症伴假血管瘤样间质增生患者乳腺组织免疫组织化学图(SP ×200) a图所示间质细胞CD34(+),CD34表达于细胞质,呈棕褐色,细胞核呈蓝色,其中血管内皮细胞细胞质中CD34呈强阳性棕褐色着色(红线圈区域);b图所示间质细胞CD31(-),CD31表达于细胞质,细胞质未着色,细胞核呈蓝色,其中血管内皮细胞细胞质中CD31呈强阳性棕褐色着色(红线圈区域)
图6 男性右侧乳房发育症伴假血管瘤样间质增生患者术后1周胸部外观 注:右侧乳房恢复男性化外观,胸部基本对称
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[1] 胡婉珍, 巩鹏. 乳腺及副乳腺假血管瘤样间质增生一例[J]. 中华乳腺病杂志(电子版), 2021, 15(04): 256-258.
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