每日一题_2023.09.15

A 21-year-old woman with no family or personal history of breast cancer presents to the clinic with a small, firm mass in the lower inner quadrant of her right breast. Palpation of the mass reveals the mass is firm, nontender, and mobile, with no overlying skin changes and no nipple discharge. There is no associated palpable axillary or supraclavicular lymphadenopathy. A urine pregnancy test is negative. Which of the following would most likely be found on histological examination of this mass?

一名21岁女性，无乳腺癌家族史或个人史，因右乳腺下内象限小而硬的肿块就诊。肿块触诊显示肿块硬，无触痛，可活动，无皮肤改变，无乳头溢液。没有相关的腋窝或锁骨上淋巴结肿大。尿液妊娠试验为阴性。下列哪一项最可能在该肿块的组织学检查中发现?

(A)  Branching fibrovascular core extending from a dilated duct从扩张的导管延伸出的分支纤维血管核心

(B)  Fibrosing stroma around normal glandular tissue正常腺体组织周围的纤维化基质

(C)  Large cells with clear “halos”带有清晰“光晕”的大细胞

(D)  Parallel arrays of small, monomorphic cells with scant cytoplasm细胞质稀少的小的、单形的细胞平行排列

(E)  Sheets of pleomorphic cells infiltrating adjacent stroma多形性细胞片浸润邻近间质

答案解析：

纤维腺瘤是最常见的乳腺良性肿瘤，好发于20 ~ 35岁的年轻女性。表现为小的、坚硬的、可移动的团块。与恶性进展无关。组织学上，正常导管和腺体周围可见小叶间质纤维化。纤维腺瘤常为单发、边界清楚、有弹性、无痛性肿块。它们在月经周期对激素有反应，经常变成玻璃样变和钙化，在乳房x线摄影上类似乳腺癌。稳定的纤维腺瘤在年轻女性通常进行超声检查;但是，如果怀疑恶性肿瘤或肿块增大，应进行细胞学检查。

正确答案：B