乳腺导管内乳头状瘤超声误诊分析  

Ultrasound Misdiagnosis of Intraductal Papilloma of the Breast

作　　者：查珣 姥义 吴晓燕 杨星 ZHA Xun;MU Yi;WU Xiaoyan;YANG Xing(Department of Ultrasound,the 904th Hospital of Joint Logistics Support Force of the People's Liberation Army,Wuxi,Jiangsu 214000,China)

机构地区：[1]联勤保障部队第九〇四医院超声科,江苏无锡214000

出　　处：《临床误诊误治》2023年第10期39-43,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨乳腺导管内乳头状瘤(IDP)超声特点及超声误诊的原因。方法回顾性分析2020年3月—2023年3月收治的行手术治疗的IDP 19例的临床资料,其中11例超声误诊,8例确诊。结果19例中以单纯乳头溢液就诊3例,以乳房肿块就诊13例,以乳头溢液合并乳房肿块就诊3例。导管扩张伴导管内实性乳头状突起型5例未误诊;导管扩张伴远端中断处实性结节型9例中3例未误诊,误诊6例,误诊为乳腺癌3例、单纯导管扩张2例、纤维腺瘤1例;囊实性结节型1例,误诊为乳腺癌;实质性结节型4例,误诊为纤维腺瘤3例、乳腺癌1例。19例均经手术病理检查确诊IDP。术后随访1年,均未见复发,预后良好。结论IDP早期超声声像图和临床表现不典型,易误诊;临床医生熟知IDP超声表现,仔细观察肿物边缘及其包膜情况,必要时可局部扩大观察并行彩色多普勒血流显像检查,仔细鉴别诊断,结合临床,可一定程度避免早期超声误诊的发生。Objective To investigate the ultrasonographic characteristics of intraductal papilloma(IDP)of the breast and the causes of misdiagnosis.Methods The clinical data of 19 patients with IDP who underwent surgical treatment from March 2020 to March 2023 were retrospectively analyzed.Among them,11 cases were misdiagnosed by ultrasound and 8 cases were confirmed.Results Among the 19 patients,3 presented with simple nipple discharge,13 with breast mass,and 3 with nipple discharge combined with breast mass.Ductal dilation with intraductal solid papillary type was not misdiagnosed in 5 cases.Of the 9 cases with ductal dilation and solid nodules at distal interruption,3 were not misdiagnosed,6 were misdiagnosed;3 cases were misdiagnosed as breast cancer,including 2 as simple ductal dilation,and 1 as fibroadenoma.One case of cystic nodular type was misdiagnosed as breast cancer.There were 4 cases of parenchymatous nodular type,including 3 cases misdiagnosed as fibroadenoma and 1 case as breast cancer.All the 19 cases had IDP which was confirmed by pathological examination and followed up for 1 year after operation.No recurrence was found and the prognosis was good.Conclusion Early IDP ultrasonography and clinical manifestations are not typical,which is more likely to cause misdiagnosis.Clinicians should be familiar with ultrasound manifestations of IDP,carefully observe the tumor margin and envelope,and if necessary,locally expand the observation,perform color Doppler flow imaging examination,and carefully differentiate diagnosis,combined with clinical practice,to avoid early ultrasound misdiagnosis to a certain extent.

关 键 词：乳腺导管内乳头状瘤 误诊 乳腺导管扩张 纤维腺瘤 乳腺癌 超声检查 彩色多普勒血流显像 病理学 分子 

分 类 号：R737.9[医药卫生—肿瘤]