2例乳腺纤维瘤病影像学征象及临床病理分析并文献复习

Imaging Features and Clinicopathological Manifestations of 2 Cases of Breast Fibromatosis and RelatedReference Review

目的探讨乳腺纤维瘤病的影像学及临床病理特点、免疫表型和鉴别诊断。方法回顾性分析淮安市妇幼保健院2003年9月至2013年9月收治的2例乳腺纤维瘤病样的影像学改变、病理形态学改变和免疫表型。结果 2例乳腺纤维瘤病超声及钼靶均提示恶性征象,镜下由梭形细胞和胶原纤维组成,而且瘤细胞雌激素受体、孕激素受体、雄激素受体、上皮细胞膜抗原、细胞角蛋白5/6、CD34、P63和S100蛋白均阴性。结论乳腺纤维瘤病为少见的乳腺良性肿瘤,临床及影像检查容易误诊,确诊依靠病理。需与梭形细胞癌、肌上皮癌、肌纤维母细胞瘤、纤维肉瘤、结节性筋膜炎和乳腺反应性梭形细胞结节等病变进行鉴别。

Objective To explore the imaging and clinicopathological features,immunohistochemical type and differential diagnosis of breast fibromatosis.Methods The clinical data of two cases of patients with breast fibromatosis treated in Huai＇an Maternal and Child Heahh Care Hospital from Sep.2003 to Sep.2013 were retrospectively analyzed,changes of imaging and pathomorpholohy features as well as the immunophenotype of the two cases were analyzed.Results Results of doppler uhrasound and mammography examination of the two cases showed that the tumors presented as malignant signs.And both of the neoplasms were composed of spindle cells and collagen tissues,and ER,PR,AR,EMA,CK5/6,CD34,P63 and S100 protein were all negative in tumor cells.Conclusion Fibromatosis is a rare kind of benign breast tumor,which is easy to be misdiagnosed by clinical and imaging examination.Its final diagnosis relies on pathology.It should be distinguished from other spindle cell lesions in the breast,such as fibromatosis-like spindle cell carcinoma,myoepithelial carcinoma,myofibroblastoma,fibrosarcoma,nodular fasciitis,reactive spindle cell nodules,etc.