乳腺原发性及继发性淋巴瘤的X线及MRI影像表现分析  

Mammographic and MRI appearance of primary breast lymphoma and secondary breast lymphoma

作　　者：周长玉[1] 许茂盛[1] 喻迎星[1] 卜阳阳[1] 凌东亚[1] 饶敏 ZHOU Changyu;XU Maosheng;YU Yingxing;BU Yangyang;LING Gdongya(Department of Radiology,The First Affiliated Hospital of Zhejiang Chinese Medicine University,Hangzhou 310053,P.R.China;Ruijin Hospital,Medical School of Shanghai Jiaotong University,Shanghai 201801,P.R.China)

机构地区：[1]浙江中医药大学附属第一医院影像科,浙江杭州310053 [2]上海交通大学医学院附属瑞金医院北院,上海201801

出　　处：《医学影像学杂志》2018年第5期762-765,共4页Journal of Medical Imaging

基　　金：浙江省医药卫生平台计划项目(编号:2016RCB001)

摘　　要：目的分析原发性及继发性乳腺淋巴瘤的X线及MRI表现。方法收集经病理或临床诊断标准确诊原发性及继发性乳腺淋巴瘤15例,年龄32~81岁,平均(43.5±14.6)岁,评价患者X线及MRI影像学表现。结果 4例行X线检查,2例PBL表现为单发类圆形等高密度肿块影,边界清晰;1例PBL表现为区域性团片密度增高影内伴等高密度结节影;1例SBL表现双乳多发类圆形结节,等高密度,边缘模糊。14例行MR检查,12例PBL中单乳单发结节或肿型块7例(58.3%,7/12),多发结节或肿块型4例(33.3%,4/12),双乳弥漫浸润型1例(8.3%,1/12),其中增强后可见病灶实质明显强化伴穿行血管、分隔样强化或不强化分隔,晚期病灶边缘勾边样强化5例,3例皮肤不同程度增厚水肿,7例伴腋下淋巴结肿大。SBL中1例表现为边缘清晰单发肿块,增强早期可见病灶内穿行血管,晚期分隔样强化伴病灶勾边样强化,伴双侧腋下多发肿大淋巴结;1例表现为双乳多发结节,均匀强化伴少许不强化分隔。结论原发性及继发性乳腺淋巴瘤的影像学表现具有一定的特征性,但两者的影像学表现并无明显差异,X线特点缺乏特异性,MRI表现有助于明确诊断。Objective To analyze the imaging features of primary breast lymphoma and secondary breast lymphomas on mammography and MR. Methods Totally,there were 15 cases（age 32 ~ 47）,the mean age（43. 5 ± 15. 0） years old. All patients confirmed by histopathology or clinical diagnostic criteria were retrospectively analyzed in the study. The clinical findings and imaging features of mammography and MR were evaluated. Results On mammography,2 PBL showed a single high density mass with circumscribed margin,1 PBL showed regional indistinct opacity with a high density mass in it,1 SBL showed multiple nonspiculated masses. On MRI,PBL showed an unilateral single mass in 7（16. 7%,7/12）,multiple masses in 4（33. 3%,4/12）,diffuse infiltrative lesions in 1（8. 3%,1/12）. DCE MR images showed early homogeneous enhancement of the lesions with penetrating vessels,hyperintense linear enhancement or hypointense septal unenhancement. On the delayed images,peripheral enhancement with a crispening appearance were observed in 5 cases,skin thickness in 3 cases,axillary adenopathy in 7 cases. 1 SBL showed an unilateral single mass with circumscribed margin. DCE MR images showed early homogeneous enhancement of the lesions with penetrating vessels,hyperintense linear enhancement and peripheral enhancement with a crispening appearance on the delayed images. 1 SBL showed bilateral multiple masses,with homogeneous enhancement and segment unenhancement. Conclusion PBL and SBL have some characteristic imaging features,but there is no significant difference in the imaging features of lesions between PBL and SBL,the features of mammography are not specific,but MRI is helpful to diagnose breast lymphoma.

关 键 词：淋巴瘤 乳腺肿瘤 乳腺X线摄影 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]