Lobuläre Neoplasie und invasives lobuläres Mammakarzinom
Tóm tắt
Der Begriff der lobulären Neoplasie (LN) beinhaltet die atypische lobuläre Hyperplasie (ALH) und das lobuläre Carcinoma in situ (LCIS). Er umfasst ein Spektrum morphologisch heterogener, aber klinisch und molekularbiologisch verwandter Läsionen. Die LN gilt als nichtobligate Vorläuferläsion des invasiven Mammakarzinoms und gleichzeitig als Indikatorläsion für ein ipsi- und kontralaterales Karzinomrisiko der Patientin. Die seltenen pleomorphen und floriden Varianten des LCIS werden vom klassischen LCIS abgegrenzt. Das invasive lobuläre Mammakarzinom (ILC) unterscheidet sich vom nicht speziellen Typ des invasiven Mammakarzinoms (NST) durch E-Cadherin-Inaktivierung, Verlust der E-Cadherin-vermittelten Zelladhäsion und dem dadurch bedingten diskohäsiven Zellbild beim klassischen ILC. Variante Formen des ILC können vom klassischen Typ abweichende molekulare Eigenschaften und bei den gering differenzierten Formen solide und pleomorphe Differenzierungsmuster aufweisen. Für die Prognoseabschätzung des ILC sind Grading und die Abgrenzung von Varianten wichtige Parameter.
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