乳腺叶状肿瘤的临床与X线钼靶分析

The mammographic and clinical feature of phyllodes tumor of the breast

目的分析乳腺叶状肿瘤(PT)的临床与X线钼靶表现的关系。方法回顾分析12例经手术病理证实的PT的临床及X线钼靶资料。结果 12例PT临床均以无痛肿块就诊,多数患者短期内有突然增大病史。所有病例均行X线钼靶摄片,患者病灶表现为圆形或卵圆形(4例)、分叶状(7例)及不规则形(1例)的密度高于邻近乳腺腺体的肿块,其中6例肿块边缘见"透亮晕征",所有肿块边缘清晰(7例)或边缘不清(5例),2例可见钙化,肿块多数直径大于3 cm;所有病例均未发现邻近皮肤增厚、乳头回缩、周围乳腺结构扭曲等恶性征象。结论 PT的临床及X线钼靶表现有一定特点,中年妇女肿块较大,周边可见"透亮晕征",临床上有短期内可突然增大病史有助于PT的诊断,确诊有待手术切除后病理结果。

Objective To analyse the clinical and X-ray mammography of breast phyllodes tumor （FT）. Methods The mammo- graphic and clinical data of 12 PT patients with pathologically proved malignant（n=2）, low grade malignant（n=8）, and benign（ n=2）were ana- lyzed retrospectively. Results All patients were female. Painless breast lump was the commonest presentation, most of which grew rapidly in short time. Mammography showed round or ovoid （n=4）, lobulated （n=7） and irregular （12=1）masses with higher density than the surrounding breast tissue. The tumor margin was defined（n=7）, undefined（n=5）, or had a clear halo （n=6）. Two cases had calcification. Most of the masses were more than 3 cm in diameter. The malignant signs, such as skin thickening, nipple retraction or distortion of perifocal structures were ab- sent. Conclusion The mammographic and clinical signs of breast phyllodes tumor are characteristic： a large mass, with a clear halo, in mid- die-aged women, and rapid growth which contributes to diagnosis, but the final diagnosis depends on the excisional biopsy.