عضو : السلام عليكم ورحمة الله امى عندها 51 سنة شعرت بكتلة فى الثدى وقامت باجراء اشعة عليها فوجدتها كيس دهنى ولاكن يوجد كتلة صغيرة فقمنا بعمل تحليا على هذة الكتلة وظهرت النتيجة كما يلى Gross: multiple greyish brown tissue cores, the longest measured 1.2 cm long , totally submitted microscopic: serial section examined from the specimen revealed cores of tumour tissue formed of irregular groups of malignant ductal cells , showing moderate nuclear pleomorphism and hyperchromasia . there is poor attempt at tubular. the mitotic index is low .there is no intraductal component diagnosis: US guided tru cut biopsy , INFILTRATING duct carcinoma grade 2
وبعد ذلك قامت امى بعملية استئصال للثدى بالكامل وقمنا بتحليل الثدى وكانت نتيجة التحليل كما يلى


Gross: specimen received consists of MRM measured 24*16*6.5 cm, skin measured 20*14 cm. nipple and areola are free. cut section revealed a mass with firm gritty tumour tissue with ill defined borders measured 1.8*1*1.5 cm . there was a cyst measured 3 cm in maximal diameter filled with clear yellowish serous fluid. the surgical margins are free. 2 cm from deep margin .4.5 cm from skin. dissection of the axilla revealed 12 lymph nodes, the largest 3*2*2 cm , with grayish cut section Microscopic: sections examined from the specimen received revealed breast tissue showing infiltrating tumour tissue formed of irregular groups of malignant ductal cells showing moderate nuclear pleomorphism,hyperchromasia .there is moderate attempt at tubular formation. the mitotic index is low. no tumour emboli. no tumoral necrosis. there is marked desmoplasia. no intraductal component. The surrounding breast tissue showed fibrocystic disease changes and apocrine metaplasia sections from the nipple and areola are free surgical margins are free. sections examined from the axillary nodes revealed no metastatic deposits in 12 nodes. The lymph nodes showed intact fibrous capsule, preserved architecture,patent subcapsular sinuses and reactive follicles. The medullary sinuses are patent. DIAGNOSIS: Right breast,MRM,INFILTRATING DUCT CARCINOMA GRADE II,T 1,NO INTRADUCTAL COMPONENT,NO AXILLARY LYMPH NODE METASTASIS ,L.N. 0/12

وبعد ذلك قمنا بعمل تحليل الباثولوجى للعينة وكانت كالتالى
IMMUNOHISTOCHEMISTRY REPORT technique: sections were prepared from the paraffin block, processed in benchmark xt (ventana) and stained by rabbit monoclona antibodies using DAB as chromogen and hematoxylin as counter-stain the sections were treated against Estrogen receptors. Progesterone receptors. HER 2 (stained by rabbit monoclonal antibodies(DAKO-Envision FLEX using DAB as chromogen and hematoxylin as counter stain the sections were treated against ki-67 :RESULTS sections treated for Estrogen recptors revealed POSITIVE nuclear staining by chromogen. sections trated for Progesterone receptors revealed POSITIVE nuclear staining by chromogen. sections treated for HER2 revealed MINIMAL INCOMPLETE FAINT CELL MEMBRANE STAINING. 17%of tumor cells are POSITIVE for KI 67 :CONCLUSION :Block, TUMMOUR CELLS ARE POSTIVE FOR ESTROGEN RECEPTORS SCORE 8/8 POSITIVE FOR PROGESTERONE RECEPTORS SCORE 8/8 NEGATIVE FORE HER2 PROTIN OVEREXPRESSION, SCORE+1 THE PROLIFERATION INDEX FOR KI 67 IS 17%. ارجو منك يا دكتور شرح التقرير وهل مؤشراتة طيبة ام لا وان تعرفنى البروتوكول المتبع فى حالة والدتى هل يلزم كيماوى لحالة والدتى وان كان لازم ما نوع الكيماوى الواجب اخذة وما اعراضة الجانبيه وعدد الجرعات الازم اخذها وهل هناك علاجات اخرى يجب ان تاخذها والدتى من اشعاعى وهرمونى
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