涎腺乳腺转移癌的超声表现和临床病理特点  

Ultrasound Manifestations and Clinicopathological Feature of Salivary Gland Metastasis of Breast Cancer

作　　者：苏唤忠 吕国荣 苏毅明[1] 张晓东[1] 白冬雨[3] Su Huanzhong;Lyu Guorong;Su Yiming;Zhang Xiaodong;Bai Dongyu(Department of Ultrasound,the First Affiliated Hospital of Xiamen University,Xiamen,Fujian 361003,China;Collaborative Innovation Center of Maternal and Child Health Service Technology,Quanzhou Medical College,Quanzhou,Fujian 362000,China;Department of pathology,the First Affiliated Hospital of Xiamen University,Xiamen,Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院超声影像科,福建省厦门市361003 [2]福建省泉州医学高等专科学校母婴健康服务应用技术协同创新中心,福建省泉州市362000 [3]厦门大学附属第一医院病理科,福建省厦门市361003

出　　处：《中国超声医学杂志》2022年第9期992-995,共4页Chinese Journal of Ultrasound in Medicine

基　　金：泉州医学高等专科学校母婴健康服务应用技术协同创新中心资助(No.XJM1803)。

摘　　要：目的探讨涎腺乳腺转移癌(SMBC)的临床病理特点、超声表现及其诊断价值。方法回顾性分析4例病理证实为SMBC患者的临床、超声及病理资料。结果4例SMBC,3例位于腮腺,1例位于颌下腺;声像图均表现为边界不清晰、形态不规则、边缘毛糙、内部回声不均匀或欠均匀的实性低回声结节;3例(3/4)与被膜分界不清,1例(1/4)突破被膜;1例(1/4)病灶内部见微钙化;4例结节均于内部及周边探及Ⅱ级血流信号。3例(3/4)SMBC为异时性转移,所有患者同时伴全身其他部位转移。病理类型均为乳腺浸润性导管癌,免疫组化3例(3/4)雌激素受体(ER)阳性,1例(1/4)孕激素受体(PR)阳性,3例(3/4)人表皮生长因子受体-2(HER-2)阳性,Ki-67平均阳性率35%。结论SMBC具有涎腺恶性肿瘤的超声声像特征,当患者既往有乳腺癌病史时,超声医师应该警惕SMBC的可能,并建议穿刺活检以明确诊断。Objective To investigate the clinicopathological features,ultrasound manifestations and diagnostic value of ultrasonography in salivary gland metastasis of breast cancer(SMBC).Methods The clinical,ultrasonographic and pathological data of 4 patients with SMBC which confirmed by pathology were retrospectively analyzed.Results Of the four SMBC cases,3 cases were located in the parotid gland,1 case was located in the submandibular gland.The sonographic images showed solid hypoechoic nodules with unclear borders,irregular shapes,rough edges and heterogeneous echoes.3 cases(3/4)showed an unclear boundary between the salivary gland capsule and the mass,1 case(1/4)broke through the salivary gland capsule.1 case(1/4)had microcalcification inside the lesion.4 cases had gradeⅡblood flow signals in the interior and periphery.3 cases(3/4)of SMBC were metachronous metastases,and all patients had metastases in other parts of the body at the same time.Histologically,all of the pathological types were invasive ductal carcinoma of the breast.Immunohistochemically,3 cases(3/4)were estrogen receptor(ER)positive,1 case(1/4)was progesterone receptor(PR)positive,3 cases(3/4)were human epidermal growth factor receptor-2(HER-2)positive,and the average positive rate of Ki-67 was 35%.Conclusions SMBC has the sonographic features of salivary gland malignancies.When the patients have a prior history of breast cancer,sonographers should be alert to the possibility of SMBC and recommend percutaneous needle biopsy for the confirmation of diagnosis.

关 键 词：涎腺转移 乳腺癌 超声检查 病理检查 

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]