原发性乳腺淋巴瘤的影像表现  

Imaging manifestations of primary breast lymphoma

作　　者：李孟磊 肖纪涛 陈允志 孙士庆[3] LI Menglei;XIAO Jitao;CHEN Yunzhi;SUN Shiqing(Department of Radiology,Liaocheng Second People's Hospital,Liaocheng 252600,China;Department of Radiology,Jining People's Hospital,Jining 272007,China;Department of Imaging,Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]山东省聊城市第二人民医院放射科,山东聊城252600 [2]山东省济宁市第一人民医院放射科,山东济宁272007 [3]青岛大学附属医院影像科,山东青岛266000

出　　处：《医学影像学杂志》2023年第6期1016-1019,共4页Journal of Medical Imaging

摘　　要：目的探讨乳腺X线摄影、超声检查和磁共振成像(MRI)联合的多模态影像模式对原发性乳腺淋巴瘤的诊断价值。方法选取14例经手术或病理证实的原发性乳腺淋巴瘤的影像资料,分析和总结其乳腺X线摄影、超声检查和MRI的特征性表现。结果14例患者中13例为单侧乳腺单发病灶,1例为双侧乳腺多发病灶,9例伴腋窝肿大淋巴结。9例患者行乳腺X线摄影检查,均未见毛刺征及钙化,7例表现为肿块影,边缘模糊或部分模糊,1例表现为非对称致密,1例病灶未能显示。13例患者行超声检查,均表现为以低回声为主的高低混杂回声,无后方回声衰减,边缘清晰,质地较软,彩色多普勒可见内部或周边丰富血流信号。7例患者行MRI检查,表现为T1WI低信号,抑脂T2WI高信号或稍高信号,信号较均匀,动态增强早期明显均匀强化,DWI明显高信号,ADC值(0.36~0.74)×10^(-3)mm^(2)/s。肿瘤最大径为1.5cm~14.5cm,中位直径为5cm。结论原发性乳腺淋巴瘤的超声和MRI表现具有相对特异性,乳腺X线摄影表现缺乏特异性,且常常低估其恶性程度,多模态的影像特点可以提示原发性乳腺淋巴瘤的诊断。Objectives We aimed to investigate the value of multimodality imaging mode combined with breast X-ray,ultrasound and magnetic resonance imaging(MRI)in the diagnosis of primary breast lymphoma(PBL).Methods We retrospectively analyzed the imaging findings of 14 cases of primary breast lymphoma proved by operation or pathology,and summarized the characteristic manifestations of X-ray,ultrasound and magnetic resonance imaging.Results Among the 14 patients,13 cases were single lesion of unilateral breast,1 case was multiple lesions of bilateral breast,9 patients had axillary enlarged lymph nodes.9 patients underwent X-ray examination and no spiculation sign and calcification were found.7 cases showed mass,and the edge was blurred or partially blurred,1 case showed asymmetric density,1 case had no positive findings.13 patients underwent ultrasonography and showed high and low mixed echoes,no posterior echo attenuation,clear edge and soft texture.Color Doppler showed abundant blood flow in the interior or edge of the mass.7 patients underwent MRI showing as uniform low signal on T1 weighted image(T1WI),high signal or slightly high signal on Fat suppression T2 weighted image(FS T2WI),obvious uniform enhancement in the early stage of dynamic enhancement,and obvious high signal on diffusion-weighted imaging(DWI).Apparent diffusion coefficient(ADC)was(0.36~0.74)×10^(-3)mm^(2)/s.The maximum diameter of the tumor was 1.5 to14.5cm,and the median diameter was 5 cm Conclusions Ultrasound and MRI findings of primary breast lymphoma are specific.X-ray findings are lack of specificity,and the degree of malignancy is often underestimated.Multimodality imaging features can suggest the diagnosis of primary breast lymphoma.

关 键 词：原发性乳腺淋巴瘤 超声检查 乳腺X线摄影 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R445[医药卫生—临床医学]