乳腺淋巴瘤超声检查误诊13例临床分析

Clinical Analysis of 13 Misdiagnosed Patients with Breast Lymphoma by Ultrasonography

目的探讨乳腺淋巴瘤超声检查误诊原因及防范措施。方法对2004年1月—2016年5月安康市中心医院收治的乳腺淋巴瘤72例中超声检查误诊的13例的临床资料进行系统性回顾分析。结果本组均因乳腺肿物就诊,超声检查误诊为左侧乳腺癌3例,左侧乳腺癌伴左侧腋窝淋巴结转移1例,左侧乳腺炎2例;右侧乳腺癌2例,右侧乳腺癌伴右侧腋窝淋巴结转移1例,右侧乳腺纤维瘤1例;双侧乳腺癌3例。13例均行手术治疗,术后病理及免疫组织化学检查确诊为非霍奇金淋巴瘤Ⅱ期,B细胞来源4例;非霍奇金淋巴瘤Ⅲ期,B细胞来源5例;非霍奇金淋巴瘤Ⅱ期,T细胞来源3例;非霍奇金淋巴瘤Ⅲ期,T细胞来源1例。13例确诊后均予相应化学治疗后病情稳定出院;出院后随访10~12个月,5例死亡,8例存活。结论乳腺淋巴瘤临床表现及相关医技检查结果复杂多样且缺乏特异性,易误诊。临床医生应加强对其实验室及影像学检查结果的认识和了解,提高对其病理学检查的重视程度,以减少或避免乳腺淋巴瘤误诊。

Objective To investigate misdiagnosed causes and preventative measures of breast lymphoma by ultrasonography.Methods Clinical data of 13 misdiagnosed patients by ultrasonography, in whom 72 patients with breast lymphoma had admitted during January 2004 and May 2016, was retrospectively analyzed.Results The 13 patients visited doctors for breast tumor, and 3 patients were misdiagnosed as having left-side breast cancer, 1 as having left-side breast cancer associated by left-side axillary lymph node metastasis and 2 as having left-side mastitis;2 patients were misdiagnosed as having right-side breast cancer, 1 as having right-side breast cancer associated by right-side axillary lymph node metastasis and 1 as having right-side breast fibroids;3 patients were misdiagnosed as having bilateral breast cancer by ultrasonography.All patients underwent surgical treatment.Postoperative pathological and immunohistochemistry examinations showed that there were 4 patients with stage Ⅱ non-Hodgkin＇＇s lymphoma and B cell source, 5 patients with stage III non-Hodgkin＇＇s lymphoma and B cell source, 3 patients with stage II non-Hodgkin＇＇s lymphoma and T cell source, and 1 patient with stage III non-Hodgkin＇＇s lymphoma and T cell source.All patients were discharged after having stable condition by corresponding chemotherapy.The patients were followed up for 10-12 months after discharging, 5 patients died, and 8 patients survived.Conclusion Clinical manifestations and findings of medical examinations for patients with breast lymphoma are complex and lack specificity, and therefore it is easily misdiagnosed.Clinicians should strengthen understanding of results by laboratory and imaging examinations and enhance the attention degree to pathological examination, in order to avoid the misdiagnosis of breast lymphoma.