乳腺导管内乳头状瘤病的诊疗分析  

Analysis of diagnose and treatment of breast intraductal papillomatosis

作　　者：陈守菊 刘福川 刘文莉 

机构地区：[1]中心医院乳腺科,四川省达州市635000 [2]中心医院病理科,四川省达州市635000 [3]中心医院放射科,四川省达州市635000

出　　处：《中国实用医刊》2011年第7期3-5,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨乳腺导管内乳头状瘤病的临床、影像学特点及其与病理变化的关系。方法回顾性分析我院近4年来诊治的57例导管内乳头状瘤病患者的临床资料，复习其临床表现、影像学及组织学特点。结果57例患者平均年龄40．46岁，其中29—40岁占57．89％，乡镇居民36例（63．16％）。病理合并非典型增生27例（45．76％）。57例临床表现为乳头溢液或（和）乳痛伴或不伴乳腺包块半月～5年余。钼靶摄影提示为乳腺增生，造影可提示导管内乳头状瘤。彩超可见弱回声或实性回声结节，界清～蟹足状不清，CDFI结节内无～线状～明显有血流信号不等。合并癌变者钼靶示成簇点状钙化，导管扩张、僵硬，邻近导管斑片状造影剂散布；彩超见弱回声团，界限欠清，回声均质无钙化或不均质有点状强回声钙化且血流丰富。18例患者行包块单纯切除，切除边界距病变外约0．5cnl。其余全部行术中冷冻病检，细胞生长活跃或不典型者，将瘤体所在腺叶楔形切除；恶变者行改良根治术。其中有4例患者于术后0．5～1．6年复发，后行乳段切除术。结论导管内乳头状瘤病多合并乳头溢液，钼靶造影诊断较敏感，但确诊需病检。治疗以手术切除为主，多伴非典型增生，术后需加强回访。Objective To explore the clinical and image features of breast intraductal papillomatosis and their relationship with pathological change. Methods The clinical manifestitions, images and his- tologie features of 57 cases of intraduetal papillomatosis were retrospectively analysed. Results The mean age of patients was 40.46 years old ,and the rate was 57.89% between the 29 to 40 years old, the occupation of small towns＇ residents were 36 eases（63.16% ）. There were 27 patients（45.76% ） had intraductal papillomatosis associated with atypical hyperplasia. Nipple discharge or/and mastalgia associated with or without mass persisted half - month to 5 years more long time were the clinical manifestition. Hyperplasia of mammography and intraductal papillomatosis of galaetography were indicated. Solid eehopattem or weak echonodus were seen on color ultrasound, and bloodstream signals were different from no to line and signifi- cance in the node. Clustering punctate calcifications and patching contrast agent dispersal in eircaduct and the ductal ectasia or rigidity were showed up on the mammography when combined carcinoma. Weak echo clump and unclear boundary with or without punctiform calcification and abundance bloodstream were seen on the color ultrasound. The masses of 18 patients were simple resected around 0. 5 em from the boundary. The gland lobe wedge resection were practiced which freezing slide showing cell growth active or atypical and improved radical correction were done to those who were malignant. There were four patients recur after postoperation from half year to one year and seven months and galactosegment ectomy were performed. Conclusions Most intraductal papillomatosis complicated with nipple discharge and fairly sensitivity to mammography but final diagnosis required biopsy. Exairesis was the principal therapeutica way and followed up need emphasized for most lesions complicated with atypical hyperplasia.

关 键 词：乳腺 导管内乳头状瘤病 

分 类 号：R737.9[医药卫生—肿瘤]