乳腺分叶状肿瘤的临床及X线钼靶表现分析

The Mammographic and Clinical Feature of Phyllodes Tumors

目的:探讨乳腺分叶状肿瘤的临床及影像学表现。方法:回顾性分析5例经手术、病理证实的乳腺分叶状肿瘤患者的临床和乳腺X线摄影资料,良性4例,恶性1例。患者均为女性,年龄20～51岁,病程1周～4年。首发症状为乳腺无痛性包块,3例患者肿块近期迅速长大。结果:所有肿块触诊质地坚韧,表面光滑,活动度好。乳腺X线摄影片共显示瘤体6个,多位于乳腺外上象限(4/6),均为高密度,无毛刺肿块,分叶形3个、圆形1个、椭圆形2个。肿块直径2.5～7.5cm。4个肿块边缘清晰、光滑,3个可见薄层透明晕环绕;另2个瘤体边缘部分清楚。肿块内未见钙化,未见异常血管像,邻近结构紊乱及腋下淋巴结增大。结论:分叶状肿瘤在临床及影像学表现上与纤维腺瘤有很多相似之处,但年龄较大的女性、乳腺发现较大肿块且短期内迅速长大应高度怀疑分叶状肿瘤可能。

Objective： To study the mammographic and clinical findings of phyllodes tumors. Methods： Clinical and imaging findings were retrospectively reviewed in 5 cases with 6 phyllodes tumors （5 benign,1 malignant） identified at preoperative mammography. Results： All patients were females, ranged in age from 20 to 51 years （mean, 35 years）, each of them respectively had a length of the history ranged from 1 week to 4 years. Painless breast lump was the commonest presentation. On clinical cxamination.all lumps were firm and mobile. The tumor was enlarging rapidly on 3 patients. On mammograms：the upper outer quadrant was the most commonly involved site （66.7 % ）. All tumors were high density, nonspiculated soft tissue masses, their shape including lobulated （n=3）,round （n=l） and oval （n=2）. The tumor diameter varied between 2.5 and 7.5cm （mean, 4.5cm）. Four of 6 tumors were sharply defined;three in them,a clear halo was seen around the mass. Endotumoral calcifications and secondary signs of malignancy were absent. Conclusion： Although many of the phyllodes tumors are indistinguishable from fibroadenoma on the basis of clinical and radiological features, in large breast tumors with rapid growth, the tentative diagnosis phyllodes tumors should be considered more often.