乳腺大汗腺癌的影像学表现

Imaging characteristics of breast apocrine carcinoma

目的回顾性分析乳腺大汗腺癌的MRI及乳腺X线特点。方法收集2009年8月-2013年5月经病理证实的乳腺大汗腺癌共19例（平均年龄66．8岁，范围51～87岁）。19例中行MRI检查和乳腺X线摄影检查各13例，其中接受2种检查者7例。分析病灶在MRI上的形态学特征、动态增强特点、时间．信号强度曲线（TIC）及乳腺X线表现。结果在乳腺X线上，13例中肿块8例、结构扭曲4例、未见明显异常者1例；肿块边缘模糊者7例，毛刺者1例；4例伴有微小钙化。在MRI上，13例中10例表现为肿块样强化、3例表现为非肿块样强化；肿块边缘毛刺者6例，不规则者4例。3例非肿块样强化的分布类型分别为区域性强化1例、多区域性强化1例、弥漫性强化1例。TIC为平台型者1例、流出型者12例。结论乳腺大汗腺癌在X线上多表现为边缘模糊的肿块，在MRI上多表现为毛刺状边缘的肿块，TIC多为流出型。乳腺大汗腺癌在影像学上多表现为恶性肿瘤的征象，无特征性表现。

Objective To evaluate the imaging features of breast apocrine carcinoma on magnetic resonance imaging （MRI） and mammography. Methods A total of 19 patients （mean age 66.8 years, range 51-87 years） with pathologically confirmed apocrine carcinoma in our hospital from September 2009 to May 2013 were retrospectively analyzed. Among 19 cases, 13 underwent breast MRI and 13 underwent mammography. There were 7 cases undergoing both MRI and mammography. MR images were reviewed for evaluation of lesion morphology, dynamic characteristics and time-signal intensity curve （TIC）. Mammographical findings were also assessed. Results Of 13 cases who underwent mammography, 8 cases showed mass and 4 showed architectural distortion. There was no abnormal finding in 1 case. The margins of masses were ill-dsfined in 7 cases and spiculated in 1 case. Microcacification was found in 4 cases. On MRI, 10 cases showed mass-like enhancement and 3 showed non-mass-like enhancement. The margins of masses were spiculated in 6 cases and irregular in 4 cases. The distribution of non-mass-like enhancement was regional （n=1）, multi-regional （n=1） and diffuse （n=l）, respectively. TIC patterns were shown to be plateau in 1 case and washout in 12 cases. Conclusion Apocrine carcinoma of the breast commonly shows an illdefined mass on mammography and mass-like enhancement with spiculated margins and a washout pattern on MRI. Breast apocrine carcinowa no specific imaging features. However, it can easily be diagnosed as a malignant tumor.