含有鳞状细胞癌成分的乳腺化生性癌的超声与病理特征

Ultrasonographic and pathological features of metaplastic carcinoma with squamous cell component of breast

目的观察含有鳞状细胞癌成分的乳腺化生性癌(MCSC)的声像图和病理学特征。方法回顾性分析7例经手术病理检查证实的MCSC患者的二维声像图及CDFI声像图特征,并与病理学表现进行对照分析。结果 7例MCSC病灶均为单发;最大径2.6~5.1cm;6例为混合回声,1例为低回声,6例病灶内均可见大小不一的无回声区;7例形态均呈微小或小分叶状、边缘模糊。CDFI显示病灶实性部分有较丰富血流,4例为Ⅲ级血流信号,2例为Ⅱ级血流信号,1例为Ⅰ级血流信号,频谱显示为高阻力动脉血流(阻力指数0.75~0.97)。术后病理大体标本示6例为囊实性,1例为实性,镜下病理5例表现为腺鳞癌,2例表现为纯鳞状细胞癌。免疫组化显示雌、孕激素受体和人表皮生长因子受体均为阴性者(三阴乳腺癌)4例。结论 MCSC声像图特征为体积较大、囊实性混合回声、瘤体后方回声增强、实性回声内血供丰富且动脉阻力高。

Objective To observe the ultrasonographic and pathological features of metaplastic carcinoma with squamous cell component（MCSC）of the breast.Methods The ultrasonographic and pathological features of 7 patients with breast MCSC confirmed pathologically were retrospectively analyzed.Results Seven cases were single lesion and the maximal diameters of the lesions were 2.6—5.1cm.On two-dimensional imaging,6 lesions with cystic and solid were complex echogenic,only 1 lesion was hypoechoic.All the lesions had irregular shape（lobulated）and indistinct margin.On CDFI imaging,most of lesions had rich blood flow signals with high resistance（resistance index 0.75—0.91）,4 lesions were grade Ⅲ,2 lesions were gradeⅡand 1 lesion was gradeⅠ blood flow signals.On gross histopathological examination,6 masses had cystic cavity,only 1 mass was pure solid.On microscopic histopathological examination,5 masses were adenosquamous carcinoma,only 2 masses were pure squamous cell carcinoma.Estrogen receptors,progesterone receptors and human epidermal growth factor receptor were negative in 4 masses（triple-negative breast cancer）.Conclusion MCSC have some distinguished ultrasonic characteristics of larger volume,cystic-solid mixed echo,posterior echo enhancement,abundant vascularity with high resistance.