目的 探討乳腺葉狀腫瘤X射線表現(xiàn)與其臨床及病理改變的相關性,以確定其不同特征及其病理組織學基礎,達到提高臨床診斷率及指導治療的目的。
方法 分析我院2010年1月至2013年1月期間經手術病理證實的28例乳腺葉狀腫瘤患者的臨床及X射線影像學資料,觀察其影像表現(xiàn)并與病理結果進行對照分析。
結果 28例乳腺葉狀腫瘤中,良性17例,交界性8例,惡性3例。X射線攝片顯示瘤體26例,另外2例僅顯示單側乳腺非對稱
致密影,其中23例均歸為BI-RADS 4類或4類以上。腫瘤直徑約2.8~10.2cm。以3cm為界,腫瘤直徑≥3cm者與<3cm者相比,出現(xiàn)良性與非良性葉狀腫瘤(交界性及惡性)的概率差異無統(tǒng)計學意義(Ρ>0.05)。良性和非良性葉狀腫瘤的分葉狀況差異也無統(tǒng)計學意義(Ρ>0.05),然而非良性葉狀腫瘤多表現(xiàn)為邊界模糊腫塊(Ρ<0.05)。2例良性葉狀腫瘤見異常血管,1例良性葉狀腫瘤見鈣化,良性葉狀腫瘤(8/17)和非良性葉狀腫瘤(2/11)出現(xiàn)“透明暈”征象比較差異無統(tǒng)計學意義(Ρ>0.05)。
結論 乳腺葉狀腫瘤的一些典型 X射線表現(xiàn)結合臨床改變有利于早期發(fā)現(xiàn)病變,但良性與非良性葉狀腫瘤的影像學表現(xiàn)無明顯差異,該病的確認及組織學分型必須依靠病理學檢查。
引用本文: 曾涵江,徐忠孜,余建群,張麗芝,羅藝,黃子星. 乳腺葉狀腫瘤X射線表現(xiàn)與臨床及病理對照分析. 中國普外基礎與臨床雜志, 2013, 20(8): 946-950. doi: 復制
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11. | 廖嘉煦, 李林. CR鉬靶聯(lián)合彩色多普勒超聲檢查對乳腺癌的診斷價值[J]. 實用醫(yī)院臨床雜志, 2010, 7(3):57-59. |
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13. | 周衛(wèi)平, 陳方滿, 劉世翠. 乳腺分葉狀腫瘤的臨床及鉬靶X線分析[J]. 皖南醫(yī)學院學報, 2008, 27(6):434-437. |
14. | D’Orsi CJ, Feldhaus L, Sonnenfeld M. Unusual lesions of the breast[J]. Radiol Clin North Am, 1983, 21(1):67-80. |
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16. | Tan H, Zhang S, Liu H, et al. Imaging findings in phyllodes tumors of the breast[J]. Eur J Radiol, 2012, 81(1):e62-e69. |
17. | Jorge Blanco A, Vargas Serrano B, Rodríguez Romero R, et al. Phyllodes tumors of the breast[J]. Eur Radiol, 1999, 9(2):356-360. |
18. | 趙玉梅, 郎榮剛, 韓鵬. 乳腺葉狀腫瘤的X線表現(xiàn)及病理對照分析[J]. 實用放射學雜志, 2009, 25(4):550-553. |
19. | Page JE, Williams JE. The radiological features of phylloides tumour of the breast with clinico-pathological correlation[J]. Clin Radiol, 1991, 44(1):8-12. |
20. | 龍威. 乳腺葉狀腫瘤的影像學表現(xiàn)分析[J]. 中國臨床醫(yī)學影像雜志, 2012, 23(2):113-115. |
21. | 葛玲玉, 王麗君, 許順良, 等. 乳腺葉狀瘤的X線表現(xiàn)與病理特征[J]. 中華放射學雜志, 2002, 36(11):977-980. |
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- 1. Liberman L, Bonaccio E, Hamele-Bena D, et al. Benign and malignant phyllodes tumors:mammographic and sonographic findings[J]. Radiology, 1996, 198(1):121-124.
- 2. WHO. Histological typing of breast tumors[A]//International histological classification of tumors[M]. 2nd ed. Geneva:WHO, 1981:19.
- 3. Tavassoli FA, Devilee P. World Health Organization Classification of Tumors. Pathology and Genetics of Tumors of the Breast and Female Genital Organs[M]. Lyon:IARC Press, 2003:268.
- 4. Berg WA, Raza S, Birdwell RL, et al. Diagnostic imaging:Breast. Part [M]. Utah: Amirsys Inc, 2006:166-176.
- 5. Rosen PP. Rosen’s breast pathology [M]. New York:LippinCott-Ray, 1996:155-172.
- 6. Gurrero MA, Ballard BR, Grau AM. Malignant phyllodes tumor of breast:review of the literature and case report of stromal overgrowth[J]. Surg Oncol, 2003, 12(1):27.
- 7. Bapat K, Oropeza R, Sahoo S. Benign phyllodes tumor of the male breast[J]. Breast J, 2002, 8(2):115-116.
- 8. Bartoli C, Zurrida SM, Clemente C. Phyllodes tumor in a male patient with bilateral gynaecomastia induced by oestrogen therapy for prostatic carcinoma[J]. Eur J Surg Oncol, 1991, 17(2):215-217.
- 9. 李席如, 馬冰, 王建東, 等. 乳腺分葉狀腫瘤8例報告[J]. 中華腫瘤防治雜志, 2007, 14(17):1339-1340.
- 10. Yilmaz E, Sal S, Lebe B. Differentiation of phyllodes tumors versus fibroadenomas[J]. Acta radiol, 2002, 43(1):34-39.
- 11. 廖嘉煦, 李林. CR鉬靶聯(lián)合彩色多普勒超聲檢查對乳腺癌的診斷價值[J]. 實用醫(yī)院臨床雜志, 2010, 7(3):57-59.
- 12. Rajan PB, Cranor ML, Rosen PP. Cystosarcoma phyllodes in adolescent girls and young women:a study of 45 patients[J]. Am J Surg Pathol, 1998, 22(1):64-69.
- 13. 周衛(wèi)平, 陳方滿, 劉世翠. 乳腺分葉狀腫瘤的臨床及鉬靶X線分析[J]. 皖南醫(yī)學院學報, 2008, 27(6):434-437.
- 14. D’Orsi CJ, Feldhaus L, Sonnenfeld M. Unusual lesions of the breast[J]. Radiol Clin North Am, 1983, 21(1):67-80.
- 15. Jellins J, Hughes C, Ryan J, et al. A comparative evaluation of a case of cystosarcoma phylloides:ultrasound, xeroradiography and thermography[J]. Radiology, 1977, 124(3):803-804.
- 16. Tan H, Zhang S, Liu H, et al. Imaging findings in phyllodes tumors of the breast[J]. Eur J Radiol, 2012, 81(1):e62-e69.
- 17. Jorge Blanco A, Vargas Serrano B, Rodríguez Romero R, et al. Phyllodes tumors of the breast[J]. Eur Radiol, 1999, 9(2):356-360.
- 18. 趙玉梅, 郎榮剛, 韓鵬. 乳腺葉狀腫瘤的X線表現(xiàn)及病理對照分析[J]. 實用放射學雜志, 2009, 25(4):550-553.
- 19. Page JE, Williams JE. The radiological features of phylloides tumour of the breast with clinico-pathological correlation[J]. Clin Radiol, 1991, 44(1):8-12.
- 20. 龍威. 乳腺葉狀腫瘤的影像學表現(xiàn)分析[J]. 中國臨床醫(yī)學影像雜志, 2012, 23(2):113-115.
- 21. 葛玲玉, 王麗君, 許順良, 等. 乳腺葉狀瘤的X線表現(xiàn)與病理特征[J]. 中華放射學雜志, 2002, 36(11):977-980.
- 22. 胡永升. 現(xiàn)代乳腺影像診斷學[M]. 北京:科學出版社, 2001:45.
- 23. Feder JM, de Paredes ES, Hogge JP, et al. Unusual breast lesions:radiologic-pathologic correlation[J]. Radiographics, 1999, 19 Spec No (1):S11-S26.