汗腺肿瘤的超声表现及误诊原因分析  

Ultrasound manifestations and misdiagnosis analysis of sweat gland tumors

作　　者：周曙 张艳芬 刘新桥 周晓晖 ZHOU Shu;ZHANG Yanfen;LIU Xinqiao;ZHOU Xiaohui(The Affiliated Changsha Central Hospital,Hengyang Medical School,University of South China,Changsha 410004,China)

机构地区：[1]南华大学附属长沙中心医院,长沙410004

出　　处：《新疆医科大学学报》2024年第11期1464-1469,共6页Journal of Xinjiang Medical University

基　　金：湖南省卫生健康委科研计划项目(20201261)。

摘　　要：目的探讨汗腺肿瘤的超声影像特点,并分析超声诊断误诊原因及影响因素,以提高超声诊断准确性和对该类疾病的认识,从而减少误诊。方法回顾性分析2009年1月至2024年7月在本院行手术切除的汗腺肿瘤87例患者的临床资料、超声检查及病理结果。结果87例病灶均位于皮下,皆为单发,平均直径约为19.7 mm(7~49 mm),54个(62%)病灶内部呈囊实性混合回声。术前高频超声仅对4例汗腺肿瘤作出正确诊断(误诊率高达88%),27例误诊为表皮样囊肿,其余被误诊为皮脂腺囊肿14例,真皮纤维瘤13例,脂肪瘤2例,基底细胞癌6例,纤维瘤4例,转移性淋巴结7例,血管瘤6例,神经鞘瘤3例,乳腺癌1例。结论汗腺瘤具有相对特异性的声像图表现,术前超声检查有助于诊断。其他类型汗腺肿瘤超声表现缺乏特异性,极易误诊,因此需要熟练掌握汗腺肿瘤的多种超声声像图表现,重视病史采集及临床表现,综合分析病灶特点及性质,掌握该类疾病鉴别诊断要点,从而减少误诊,但确诊仍需病理诊断。Objective To explore the ultrasound imaging characteristics of sweat gland tumors,and toanalyze the causes and influencing factors of ultrasound diagnosis,so as to improve the accuracy of ultrasound diagnosis and the understanding of this disease,so as to reduce misdiagnosis.Methods The clinical data,ultrasound examination and pathological results of 87 patients with sweat gland tumors removed from January 2009 to July 2024 were retrospective reviewed.Results All 87 lesions were subcutaneous,all single,with a mean diameter of 19.7 mm(8-45 mm),and 54(62%)lesions showed solid mixed echo.Preoperative high frequency ultrasound only 4 cases of sweat gland tumor to make correct diagnosis(misdiagnosis rate up to 88%),27 cases of misdiagnosed as epidermoid cyst,the rest was misdiagnosed as sebaceous cyst 14 cases,13 cases,dermal fibroma,lipoma 2 cases,basal cell carcinoma,6 cases of fibroma,7 cases of metastatic lymph nodes,6 cases,hemangioma schwannoma 3 casesand 1 case of breast cancer.Conclusion In this study,sweat adenoma has relatively specific sonogram findings,and preoperative ultrasound examination is helpful for diagnosis.The ultrasound manifestations of other types of sweat gland tumors lack spe-cificity and are easy to misdiagnosis.Therefore,it is necessary to master a variety of ultrasonic sonogram manifestations of sweat gland tumors,pay attention to the collection of medical history and clinical mani-festations,comprehensively analyze the characteristics and properties of lesions,and master the key points of differential diagnosis of such diseases,so as to reduce misdiagnosis,but pathological diagnosis is still needed.

关 键 词：汗腺肿瘤 超声表现 误诊 小汗腺腺瘤 表皮样囊肿 

分 类 号：R445.1[医药卫生—影像医学与核医学]