肉芽肿性乳腺炎的超声表现及临床、病理分析  

Ultrasonic features and clinical,histopathological characteristics of granulomatous mastitis

作　　者：鲁嘉[1] 刘赫[1] 姜玉新[1] 戴晴[1] 常晓燕[1] 朱庆莉[1] 张璟[1] 孝梦甦[1] 王红燕[1] 朱沈玲 李娜[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院超声诊断科,北京100730

出　　处：《中国医学影像技术》2011年第11期2246-2249,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(30900372)

摘　　要：目的探讨肉芽肿性乳腺炎(GM)的超声表现及临床病理特征。方法回顾性分析经病理确诊的15例GM患者的超声表现、临床症状及病理特征。结果 12例病灶位于左侧乳房,3例位于右侧;10例为单发,5例为多发;肿块大小2.10～9.70cm,平均(9.38±2.26)cm。超声均呈不均质低回声,其中6例可见无回声,4例无回声内可见细点状中-强回声;13例边界不清,形态不规则,其中4例主要表现为多个导管样回声延续,3例主要表现为分叶和成角,1例同时呈现以上2种表现,5例主要表现为弥漫性腺体回声紊乱,余2例边界清晰,为卵圆形。CDFI示12例病灶血流丰富。11例合并同侧腋下淋巴结肿大;3例伴皮肤增厚,其中1例伴皮下积液,1例窦道形成。术后病理显示2例W-S反应阳性,发现特异性猫抓病病原菌。结论 GM的主要超声表现为不均匀、不规则的低回声、多呈管样或结节样肿物内有丰富血流信号,确诊需结合临床表现及病理结果。Objective To observe the ultrasonic findings of granulomatous mastitis （GM）, as well as its clinical and histopathologic features. Methods The ultrasonic features and clinical, histopathological characteristics of 15 patients with GM confirmed by pathology were retrospectively reviewed. Results Twelve masses located in the left and 3 in the right breast. The masses located at one site in 10 patients, while at multiple sites in 5 patients. The diameters of the masses were 2.10-9.70 cm [mean （9.38±2.26）cm]. All the masses had hypo and heterogenous echo. Anechogenic liquid area was found in 6 patients and much pus reflection was found in 4 of them. Lesions in 13 patients had poor defined margins, of which 4 had multiple tubular extensions, 3 had lobulated and angulated margins, one bad the above two features and 5 had diffused parenchymal distortion. Lesions in 2 patients had well defined oval margins. Color Doppler flow imaging showed 12 cases had abundant vascularity with high velocity and low resistance index. Eleven patients had axillary lymph node enlargement. Three patients had skin thickening and one of them had subcutaneous liquid accumulation, one had formed fistula. The histopathologic examination showed W-S （Warthin-Starry） stain positive in 2 patients, with evidence of corynebacteria infection caused cat-scratch disease. Conclusion GM has some ultrasonic characteristics, including poor-defined and inhomogeneous echo, tubular or nodular structures and abundant vascularity, but the diagnosis still depends on clinical manifestations and histopathology.

关 键 词：乳腺 肉芽肿性乳腺炎 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R655.8[医药卫生—诊断学]