瘤组织学边界:推挤性或浸润性Р7Р间质细胞可表现多种间叶化生,如良恶性骨、软骨、脂肪、横纹肌和平滑肌分化,甚至出现血管肉瘤、恶纤组或血管外皮瘤。?上皮灶性大汗腺或鳞状化生?肉瘤样成分可过度增生而仅残留少量双相病变?间质粘液样变?上皮成分恶性转化,导管和小叶上皮内瘤常见,而浸润性导管癌少见Р8Р组织学分级(grade)?目前有三级分类和两级分类,WHO更主张三级别分级,因为后者对这一纤维上皮性病变谱系的两端更确定,主要依据间质细胞增生密度、核分裂、间质细胞非典型性、边界类型及间质增生程度,最新的WHO乳腺PT分级标准较前一版有所改进,但没有一种单一的形态学特征能明确地区分良恶性种类。Р9РPhyllodesРBenignРBorderlineРMalignantРTumor borderРWell circumscribed,?pushingРintermediateРinvasiveРStromal cellularityРmodestРmodestРmarkedРCellular pleomorphismРlittleРmoderateРMarkedРMitotic activityРfew if anyРintermediateРNumerous ?(more ≥10 per 10HPF)РStromal patternРUniform stromal distributionРHeterogeneous stromal expasionРMarked stromal overgrowthРMalignant heterologous elementsРrareРRareРNot monРMain histological features of the 3 tiered grading subgroups for phyllodes tumors—WHO2003Р10
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