乳腺腺样囊性癌的超声诊断  

Ultrasound Diagnosis of Adenoid Cystic Carcinoma of the Breast

作　　者：杨嘉嘉[1] 薛恩生[1] 林礼务[1] 何以敉[1] 陈永钦 

机构地区：[1]福建医科大学附属协和医院超声科,福州市350001 [2]福建医科大学附属协和医院病理科,福州市350001

出　　处：《中国超声医学杂志》2017年第6期565-567,共3页Chinese Journal of Ultrasound in Medicine

基　　金：福建省卫计委青年基金(No.2015-1-41)

摘　　要：目的探讨超声在乳腺腺样囊性癌(ACCB)诊断中的应用价值。方法回顾性分析在本院行超声检查并经病理证实的9例ACCB患者的超声声像图特征及病理组织学资料。结果 9例ACCB病灶均为单发,纵横比<1,7例为类椭圆形,2例呈分叶状;均表现为边界欠清晰的囊实性结节,其中6例为实性为主型,病灶最大径均值1.43cm,3例为囊性为主型,病灶最大径均值3.17cm;彩色多普勒显示ACCB血流信号以Ⅰ~Ⅱ级为主(8/9),为分布于病灶边缘并向内部走行的条状血流或病灶实性成分内的点状血流;病理上6例为筛状型,3例为实体型,其中5例行ER、PR、Ki67、Her-2检测,ER、PR、Her-2均为阴性,1例Ki67为阳性。结论乳腺单发的囊实性结节,并以实性为主型多见,伴有自病灶边缘穿入的条状血流,可能为ACCB较具特征性的超声表现;本研究ACCB病理上以筛状型多见,ER、PR、Her-2为三阴性表达。Objective To investigate the value of ultrasonography in the diagnosis of adenoid cystic carcinoma of the breast（ACCB）. Methods Sonographic and pathologic findings of 9 ACCB cases were retrospectively studied. Results All of the 9 ACCB lesions were solitary and with aspect ratio less than 1. Among them, 7 lesions were oval. while 2 were lobulated. All of the lesions were cystic-solid nodules, among them 6 showed solid mainly type （mean maximum diameter was 1.43 cm）, and the other 3 showed cystic mainly type （mean maximum diameter was 3.17 cm）. Most of the lesions （8./9） showed I - II color Doppler flow grade, of which the appearances showed strip blood flow signal at the edge of lesion and penetrated into the interior, or punctate blood flow signals inside the lesions. Pathologically, 6 of the all lesions showed cribriform pattern and the other 3 lesions showed solid pattern. The expres- sions of ER,PR.Ki67 and Her-2 in 5 lesions were detected. The immunohistochemieal results showed that ER,PR and Her-2 of 5 lesions were all negative, and only 1 lesion expressed Ki67. Conclusions The specific sonographic characteristic of ACCB lesions may be the solitary cystic-solid nodules, which were showed solid mainly type and strip blood flow signal at the edge of lesion and penetrated into the interior. The ACCB lesions with cribriform pattern in pathology were more common in this study, and the expressions of ER, PR and Her-2 were all negative.

关 键 词：乳腺肿瘤 腺样囊性癌 超声检查 诊断 

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]