乳腺叶状肿瘤21例的X射线检查与病理对照分析

A compared study on mammography and pathology of breast phyllodes tumor

目的探讨乳腺叶状肿瘤的临床特点、X射线表现与病理结果。方法分析21例经手术病理证实的乳腺叶状肿瘤患者的临床及X射线检查资料,观察其X射线表现并与病理对照分析。结果 21例乳腺叶状肿瘤中,良性14例,交界性6例,恶性1例。X射线片显示瘤体24个,多位于外上象限(9/24),最大径1.0～14.3 cm,高及稍高密度(21/24),等密度(3/24),分叶状(10/24),圆形及椭圆形(14/24),边界清晰及大部分清晰(20/24),边界模糊(4/24),边缘见晕环(8/24),其中1例仅显示左乳非对称性致密影,未见确切肿块。结论乳腺叶状肿瘤具有比较典型的X射线表现,结合临床资料有利于早期发现病变,但确诊主要依靠病理检查。对于年龄较大、发现乳腺较大肿块且短期内迅速长大、X射线片呈"良性肿瘤"表现,应高度怀疑叶状肿瘤可能。

Objective To investigate the characteristics of clinical,mammographic findings and the relationship with the path- ologic findings of breast phyllodes tumors. Methods 21cases of pathologically confirmed breast phyllodes tumors were retrospectively analyzed on clinical and mammographic datas. The mammographic findings were comparative analyzed with pathology. Results Of the 21 cases of breast phyllodes tumors, 14 were benign,6 were borderline and 1 was malignant. The mammographic findings suggested that the 24 masses were sit mostly on the upper outer quadrant （9/24）, maximum diameter between 1.0 and 14.3 cm, high and higher den- sity （ 21/24 ）, equal density （ 3/24 ）, lobulated （ 10/24 ）, round and oval （ 14/24 ）, clear boundaries and a clear majority （ 20/24 ）, fuzzy boundaries （4/24）,showed clear partial halo（8/24）, only one case demonstrated local high density but with on shadow zone. Conehtsion The mammographie findings of the phyllodes tumor are charateristic. Combined application of both mammography and clinical are helpful for early detection but can not differentiate its malignancy which is determined by pathology. In older cases, provided that the mass in breast grow rapidly in short period, even though the mass is painless with mammographic findings of seemingly benign, it may be considered as phyllodes tumor.