特殊类型乳腺恶性肿瘤的超声与病理图像分析  

Analysis of Ultrasound and Pathology Images for Special Types of Breast Malignant Tumors

作　　者：孟焱[1] 张丹[1] 李燕东[2] 马建月 翟林[1] 

机构地区：[1]首都医科大学附属复兴医院超声影像科,北京100038 [2]首都医科大学附属复兴医院超声影像科病理实验室,北京100038

出　　处：《中国医学影像学杂志》2015年第3期188-191,共4页Chinese Journal of Medical Imaging

基　　金：西城区可持续发展项目(SD 2014-06)

摘　　要：目的分析特殊类型乳腺恶性肿瘤的超声表现与组织结构的特点,探讨超声对其术前的诊断价值。资料与方法回顾性分析经术后病理证实的特殊类型乳腺恶性肿瘤7例患者的超声表现和病理图像的相关资料,观察病变的组织结构和乳腺各层解剖结构及病变的声像图表现,确定本组特殊类型乳腺恶性肿瘤的超声分型,记录病变的声像图特点。结果 7例患者中乳头状癌2例,黏液癌3例,淋巴瘤2例。乳头状癌肿块与周围组织界限清晰,侵犯间质,癌组织呈乳头状,致密;乳腺黏液癌见癌细胞漂浮在黏液湖中;原发乳腺淋巴瘤均为局灶性病变,为弥漫性大B细胞淋巴瘤。乳腺的超声分型分别为脂肪型3例,腺纤维1型1例,腺纤维2型3例。2例乳头状癌呈低回声,其中1例体积较大呈膨胀性生长;2例黏液癌为中低回声,后方衰减不明显,1例因钙化伴声影;淋巴瘤似无回声,呈类囊样。结论特殊类型乳腺恶性病变的组织结构及声像图表现不同于常见的浸润性导管癌,提高对少见乳腺恶性肿瘤的认识具有较高的临床价值。PurposeTo analyze the sonographic and the histological features of special types of breast malignant tumors in order to explore preoperative ultrasound diagnosis. Materials and Methods Seven cases of special types of breast malignant tumors confirmed by pathology were retrospectively investigated by ultrasound. The sonographic and histological features of the lesions were reviewed. The ultrasonogram manifestations of the breast anatomy and the lesions were observed and recorded.Results Among 7 cases, there were 2 cases of papillary carcinoma, 3 cases of mucinous carcinoma, and 2 cases of lymphoma. Microscopically, the papillary carcinoma had clear boundaries with infringing mesenchyme, and the tissues were papillary and dense. The mucinous carcinoma had cancer cells floated in mucus lake. The primary breast lymphoma was diffused large B-cell type with focal lesion. For sonography type of breast, there were 3 cases of fatty types, 1 case of fibroglandular-1 and 3 cases of fibroglandular-2. The papillary carcinoma was hypoechoic in 2 cases, one of them was expansive growth with large size. Two cases of mucinous carcinoma were hypoechoic without accompanying sound attenuation in 1 case and with accompanying acoustic shadow due to calcification in the other case. Lymphoma was apparent anechoic and cystoid.Conclusion Special types of breast malignancies have different sonographic features and histological features from the common invasive ductal carcinoma. It has high clinical significance to enhance the understanding of rare malignant breast tumors.

关 键 词：乳腺肿瘤 超声检查 乳房 病理学 外科 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.9[医药卫生—诊断学]