乳腺叶状囊肉瘤超声征象与病理对照分析

Ultrasonography and Pathological Research for Cystosarcoma Phyllode of Breast

目的:探讨乳腺叶状囊肉瘤超声影像学特征及与病理组织学的相关性。方法:回顾性分析经手术病理证实的15例乳腺叶状囊肉瘤的超声影像学表现,并与病理诊断结果进行对照,分析肿块大小、形态、内部回声、后方回声增强、有无钙化,内部血流、与周围组织有无粘连等影像学表现与病理组织学的相关性。结果:15例乳腺叶状囊肉瘤其病理组织分化呈现多样性,其中恶性分级呈低度恶性的有7例,中度恶性的有5例,高度恶性的有3例。15例乳腺叶状囊肉瘤经超声诊断为乳腺叶状囊肉瘤9例,乳腺癌4例,纤维腺瘤2例,诊断的符合率为60%。乳腺叶状囊肉瘤有多样种病理类型,超声声像图上以不均匀中低回声表现为主,主要表现为肿块大,形态分叶状;边缘清楚,多见囊性变,少见或罕见钙化,血流信号丰富。结论:乳腺叶状囊肉瘤的超声表现具有比较典型的影像特征,与其病理类型相关,超声检查对乳腺叶状囊腺瘤具有较高的诊断及临床应用价值。

Objective： To explore the relationship of ultrasonography and pathological research with the cystosarcoma phyllode of breast. Methods： 15 patients with cystosarcoma phyllodes of breast were selected and analyzed retrospectively. The tumor＇s characters such as shape, size, internal echo, posterior echo enhancement, presence of calcification, internal flow and adhesion with surrounding tissues were analyzed. Results： The histopathologic differentiation of 15 cases of cystosarcoma phyllode of breast presented obvious diversity, in which the malignant grade of 7 cases were low, that of 5 cases were moderate, that of 3 cases were highly. There were 9cases of cystosarcoma phyllode of breast, 4 cases of breast cancer and 2 cases of fibroadenoma for 15 cases of cystosarcoma phyllode of breast by ultrasound diagnosis, the coincidence rate of diagnosis was 60%. The pathology types of cystosarcoma phyllode of breast were multiplex. Mostly the cystosarcoma phyllode of breast was shown as uneven and low echo ultrasonic, big mass, leaf shape, clear edge cystic change, rare or unusual calcification and rich flow signals. Conclusion： The imaging findings of cystosarcoma phyllode of breast by ultrasonography examination are characteristic related to its pathological type. Ultrasonography was a valuable method for diagnosing phyllode cystosarcoma of breast.