乳腺侵袭性纤维瘤病超声表现及误诊分析  

Ultrasonic manifestations and misdiagnosis analysis in primary breast aggressive fibromatosis

作　　者：杨红英[1] 钏志睿 陈东[1] 李支尧[1] 罗晓茂[1] YANG Hongying;CHUAN Zhirui;CHEN Dong;LI Zhiyao;LUO Xiaomao(Department of Ultrasound,Third Affiliated Hospital of Kunming Medical University(Yunnan Cancer Hospital),Kunming 650118,China)

机构地区：[1]昆明医科大学第三附属医院(云南省肿瘤医院)超声医学科,昆明650118

出　　处：《临床与病理杂志》2020年第9期2505-2510,共6页Journal of Clinical and Pathological Research

摘　　要：回顾性分析昆明医科大学第三附属医院经病理确诊为乳腺侵袭性纤维瘤病而超声误诊的5例患者的超声图像特征及超声诊断,并分析误诊原因。5例患者均为单乳发病,左侧3例,右侧2例,病灶直径为20~48 mm,5例患者病灶二维超声均表现为不规则形状,边界不清楚,内部为低回声,后方回声稍衰减;彩色多普勒显示病灶周边及内部可见点条状血流,Adler血流分级Ⅱ~Ⅲ级;弹性成像评分为4~5分;1例患者行超声造影检查,表现为病灶稍早于周围腺体开始增强,增强形态为不均匀稍高增强,增强范围无明显扩大,未见滋养血管;5例患者同侧腋窝淋巴结均表现为"假肾征",无异常肿大淋巴结。超声诊断4例均考虑乳腺癌可能,1例因行超声造影检查,提示乳腺癌与其他疾患待鉴别,建议病检。乳腺侵袭性纤维瘤病是一种少见病,超声诊断极易误诊为恶性病变,临床工作中拟诊断乳腺恶性肿瘤,尤其对年轻患者,须结合各种超声图像特征综合分析,并考虑到该病的可能。Retrospective analysis ultrasound images and ultrasound diagnosis of 5 cases, which diagnosed as breast aggressive fibromatosis by pathology and misdiagnosed by ultrasound in our hospital, and analyze the cause of misdiagnosis. All the 5 patients had single breast disease, 3 cases on the left side and 2 cases on the right side. The diameter of the lesion was 20–48 mm. The two-dimensional ultrasound of the lesions showed irregular shape, unclear boundary, Internal low echo, slightly attenuated rear echo. Color Doppler showed a strip of blood flow around the lesion and inside, Adler blood flow classification Ⅱ–Ⅲ. The elastography score is 4 to 5 points. One patient underwent contrast-enhanced ultrasonography, which showed that the lesions began to strengthen slightly before the surrounding glands, and the enhancement morphology was slightly higher than the unevenness. The enhancement range was not significantly expanded, and no nourishing blood vessels were seen. In all cases, the ipsilateral axillary lymph nodes showed "false kidney sign" and no abnormal enlarged lymph nodes. Ultrasound diagnosis of 4 cases were considered for breast cancer, 1 case due to ultrasound contrast examination was considered that breast cancer and other diseases to be identified, and recommended medical examination. Breast aggressive fibromatosis is a rare disease. Ultrasound diagnosis is easily misdiagnosed as malignant lesions. In clinical work, when diagnose breast malignant tumors, especially in young patients, we need to consider the possibility of the disease by comprehensive analysis of various ultrasound image features.

关 键 词：侵袭性纤维瘤病 超声表现 误诊 

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]