Journal of Nippon Medical School: Vol.71 No.3 page.203

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ArticleTitle HERCEP TESTにおける特異な染色様式を契機に見出された神経内分泌成分を含む乳癌の1例　―自験例と文献的考察―

AuthorList 三枝順子¹, 大秋美治¹, 小黒辰夫¹, 清水秀樹¹, 赤坂久美¹, 京本晃典¹, 黒川実愛¹, 新井悟¹, 森修¹, 岡田進², 京野昭二³, 田中宣威³

Affiliation ¹日本医科大学付属千葉北総病院病理部
²日本医科大学付属千葉北総病院放射線科
³日本医科大学付属千葉北総病院外科

Language JA

Volume 71

Issue 3

Year 2004

Page 203-208

Received August 1, 2003

Accepted September 4, 2003

Keywords HERCEP TEST, breast cancer, neuroendocrine differentiation, HER2, neurosecretory granule

Abstract Hercep Test (DAKO) is an immunohistological screening kit to select cases of advanced breast cancer with indication for treatment with a humanized mouse monoclonal antibody to human epidermal growth factor receptor-2, trasthzumab (Herceptin). We report a case of an 84-year-old female with invasive ductal carcinoma of the right breast, whose neoplastic cells showed a unique staining pattern in Hercep Test. The cells showed an intracytoplasmic fine granular staining pattern, instead of the membranous pattern of typical breast cancer cells. This unique staining pattern suggested some special features of the neoplastic cells. This case was finally diagnosed as invasive ductal carcinoma with focal neuroendocrine differentiation by subsequent imunohistochemical and electron microscopic examinations. The neoplastic cells showed positive reactivity for grimelius stain, chromogranin A, synaptophysin, and neuronspecific enolase, as well as electron-dense neurosecretory granules (up to 150 nm in diameter). This unique staining pattern of the neoplastic cells with Hercep Test is a useful clue to detect breast cancer with neuroendocrine differentiation, which is likely to be missed in routine examination. Clinical and pathologic findings including immunohistochemical and ultrastructural findings of this case are reported, together with a brief review of the literature.

Correspondence to Junko Mieda, Department of Pathology, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inba-mura, Inba, Chiba 270-1694, Japan
j-mieda@nms.ac.jp

ArticleTitle	HERCEP TESTにおける特異な染色様式を契機に見出された神経内分泌成分を含む乳癌の1例　―自験例と文献的考察―
AuthorList	三枝順子¹, 大秋美治¹, 小黒辰夫¹, 清水秀樹¹, 赤坂久美¹, 京本晃典¹, 黒川実愛¹, 新井悟¹, 森修¹, 岡田進², 京野昭二³, 田中宣威³
Affiliation	¹日本医科大学付属千葉北総病院病理部 ²日本医科大学付属千葉北総病院放射線科 ³日本医科大学付属千葉北総病院外科
Language	JA
Volume	71
Issue	3
Year	2004
Page	203-208
Received	August 1, 2003
Accepted	September 4, 2003
Keywords	HERCEP TEST, breast cancer, neuroendocrine differentiation, HER2, neurosecretory granule
Abstract	Hercep Test (DAKO) is an immunohistological screening kit to select cases of advanced breast cancer with indication for treatment with a humanized mouse monoclonal antibody to human epidermal growth factor receptor-2, trasthzumab (Herceptin). We report a case of an 84-year-old female with invasive ductal carcinoma of the right breast, whose neoplastic cells showed a unique staining pattern in Hercep Test. The cells showed an intracytoplasmic fine granular staining pattern, instead of the membranous pattern of typical breast cancer cells. This unique staining pattern suggested some special features of the neoplastic cells. This case was finally diagnosed as invasive ductal carcinoma with focal neuroendocrine differentiation by subsequent imunohistochemical and electron microscopic examinations. The neoplastic cells showed positive reactivity for grimelius stain, chromogranin A, synaptophysin, and neuronspecific enolase, as well as electron-dense neurosecretory granules (up to 150 nm in diameter). This unique staining pattern of the neoplastic cells with Hercep Test is a useful clue to detect breast cancer with neuroendocrine differentiation, which is likely to be missed in routine examination. Clinical and pathologic findings including immunohistochemical and ultrastructural findings of this case are reported, together with a brief review of the literature.
Correspondence to	Junko Mieda, Department of Pathology, Chiba-Hokusoh Hospital, Nippon Medical School, 1715 Kamagari, Inba-mura, Inba, Chiba 270-1694, Japan j-mieda@nms.ac.jp