乳腺浸润性微乳头状癌的影像特征分析

Invasive micropapillary carcinoma(IMPC)of the breast:imaging features

目的探讨乳腺浸润性微乳头状癌(IMPC)的临床、影像及组织病理学特点。方法回顾性分析经病理证实的9例IMPC患者的影像学资料并与临床及病理结果进行对照;X线钼靶、超声及磁共振成像结果均参照美国放射学会超声乳腺影像报告和数据系统(BI-RADS)分级标准。结果钼靶摄影最常见的征象表现为边界不清的、不规则形高密度肿块影,其中3例可见肿块内的微钙化灶;超声多表现为不规则低回声肿块,边缘毛刺状,2例可见后方回声衰减;磁共振均表现为不规则形肿块影,增强扫描可见肿块内部不均匀强化,时间-信号强度曲线为廓清型或平台型。术后病理显示7例出现淋巴管侵袭,6例腋窝淋巴结肿大,1例锁骨上淋巴结肿大,免疫组织化学显示雌激素受体(ER)阳性8例。结论乳腺浸润性微乳头状癌常见淋巴管侵袭和区域淋巴结转移,其影像学表现具有典型的恶性肿瘤特征。

Objective To evaluate the clinical,imaging and histopathologic findings of invasive micropapillary carcinoma（IMPC）of the breast.Methods The image findings were reviewed and correlated with clinical,pathological results in 9 patients with IMPC.Mammographic,sonographic,and MRI findings were analyzed according to the American college of radiology′s BI-RADS lexicon.Results The most common mammography finding of IMPC was a high density irregular mass with a indistinct non-circumscribed margin,microcalcifications was found in 3 cases. Sonography showed an irregular hypochoic mass with a spiculated margins,posterior acoustic shadowing was found in 2 cases.On MRI,IMPC showed as an irregular mass with heterogenous internal enhancement and washout kinetics.Lymphovascular invasion was found in 7 cases.Axillary and supraclavicular nodal metastases were identified（6 cases and 1 cases,respectively）.Immunohistochemical showed positivities for estrogen receptor in 8 cases.Conclusion IMPC frequently results in lymphovascular infiltration and lymph node metastases,its imaging findings are highly suggestive of malignancy.