乳腺弥漫大B细胞淋巴瘤超声表现及其误诊原因分析  

Ultrasonic manifestations of breast diffuse large B cell lymphoma and analysis of misdiagnosis

作　　者：邓晶[1] 徐祎[2] 栗翠英[1] 马文婷[1] 敬雷[1] 李奥[1] 

机构地区：[1]南京医科大学第一附属医院超声医学科,南京市210029 [2]南京医科大学第一附属医院病理科,南京市210029

出　　处：《临床超声医学杂志》2017年第5期325-328,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨乳腺弥漫大B细胞淋巴瘤(DLBCL)的超声误诊原因。方法回顾性分析20例经病理确诊的乳腺DLBCL患者的临床及超声检查资料,分析其超声误诊原因。结果常规超声结合弹性成像、超声造影正确诊断乳腺淋巴瘤5例,误诊15例,其中误诊为乳腺癌10例,炎症病变4例,错构瘤1例。20例患者根据常规超声图像有无边界分为肿块型12例和弥漫型8例。9例行应变弹性成像检查,弹性评分2分5例,3分4例;1例行超声造影和剪切波弹性成像检查,超声造影呈不均匀高增强,剪切波弹性成像呈Ⅰ型。超声诊断BI-RADS 4类19例,其中4A类4例、4B类8例及4C类7例;BI-RADS 3类1例。结论 DLBCL常规超声检查极易误诊,充分认识其常规超声表现并联合超声造影及弹性成像技术可提高其诊断准确率。Objective To analysis the reasons of ultrasonic misdiagnosis for breast diffuse large B cell lymphoma（DLBCL）. Methods Data of 20 patients with breast DLBCL confirmed by pathology were included and analyzed retrospectively,and probe the causes of ultrasonographic misdiagnosis. Results Five cases were diagnosed as breast lymphoma by conventional ultrasound combined with contrast-enhanced ultrasound and elastography preoperatively.10 cases were misdiagnosed as breast cancer. 4 cases were misdiagnosed as inflammatory lesions. 1 case was misdiagnosed as breast hamartoma.The ultrasonic manifestations of 20 cases of breast DLBCL were divided into mass type（12 cases）and diffuse type（8 cases）.9 cases underwent elastography,the elastographic score of 5 cases were 2,and 4 cases were 3. 1 case showed inhomogeneous enhancement with contrast-enhanced ultrasound,the shear ware elastography presented type Ⅰ.19 cases were diagnosed as BI-RADS 4 category,including 4 cases of 4A,8 cases of 4B and 7 cases of 4C,1 case was diagnosed as BI-RADS 3 category. Conclusion Breast DLBCL is easily misdiagnosed by ultrasound.The diagnostic accuracy may be improved when fully understand the conventional ultrasound findings and combine with contrast-enhanced ultrasound and elastography.

关 键 词：超声检查 弥漫大B细胞淋巴瘤 乳腺 误诊 

分 类 号：R737.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]