乳腺叶状肿瘤26例数字钼靶X线分析

Radiographic analysis of phyllode tumor of the breast: report of 26 cases

目的分析乳腺叶状肿瘤的X线表现,探讨钼靶X线摄影对乳腺叶状肿瘤的诊断价值。方法回顾分析我院26例经手术病理证实的乳腺叶状肿瘤患者术前乳腺X线检查资料。结果26例乳腺叶状肿瘤中,良性21例(80.8%)交界性3例(11.5%)恶性2例(7.7%)。其中18例乳腺叶状肿瘤多位于外上象限,直径1.7～9.3cm,19例肿块表现为圆形、边缘光整,5例表现为分叶状,7例为多发肿块,2例为边缘模糊、有毛刺征,1例发现钙化灶,21例发现"透明晕"。结论妇女乳房内肿块大、分叶状且周边有"透明晕"是乳腺叶状肿瘤较特征的X线征象,近期肿块迅速增大有助于叶状肿瘤的诊断。X线表现与组织学分型有一定关系,边缘模糊,有毛刺提示恶性程度较高。认识乳腺叶状肿瘤的病理表现和X线特征,有助于提高术前诊断率。

Objective To evaluate the mammographic findings in patients with phyllode tumors of the breast （PTB）, and to explore the value of molybdenum target radiography in the diagnosis of phyllodes tumor. Methods Retrospective analy- sis of breast X-ray data of 26 cases confirmed by pathology in patients with phyllodes tumor was performed before surgery. Results In all 26 patients, PTB was pathologically diagnosed as benign tumor in 21 patients （80.8%）, borderline in 3 pa- tients （11.5%）, andmalignant in 2 patients （7.7%）. 18 cases were located in the upper outer quadrant, diameter 1.7- 9.3 cm, 19 cases of mass were round and with smooth margins, 5 cases manifested as lobulated, 7 cases were multiple mass, 2 cases presented with blur edgesand spicular signs, 1 case with calcifications, 21 cases with ＂transparent dizzy＂. Conclusion The characteristics of X-ray signs of breast phyllode tumor were large mass, lobulated and with ＂transparent dizzy＂ . Mass enlarged rapidly may help diagnose breastr phyllode tumor. There was a relationship between X-ray sign and histological type, X-ray signs of blur edges or Spicular signs were more malignant. Understanding of the pathological man- ifestations and X-ray features of phyllodes tumor is helpful to improve the rate of preoperative diagnosis.