乳腺原发性鳞状细胞癌的影像及临床病理特征分析

Imaging and Clinicopathologic Features of Primary Squamous Cell Carcinoma of Breast

目的分析乳腺原发性鳞状细胞癌的影像学特征及临床病理特征。方法回顾性分析2012年5月至2020年2月就诊于本院的并经活检或手术病理证实的12例乳腺原发性鳞状细胞癌患者。所有患者入院1周内行乳腺X线摄影、超声或MRI检查,并均获得完整影像学及临床病理资料。结果 7例病变位于右乳,5例位于左乳。行乳腺X线摄影检查12例,表现为单纯肿块9例,肿块伴钙化3例,表现为高密度10例,表现为等密度2例;肿块边缘毛刺2例,边缘分叶3例,边缘局部遮蔽1例,边缘模糊6例;原发灶平均大小为(30.5±16.5)mm。行乳腺超声检查10例,原发灶超声表现为不均质低回声7例,囊实性回声3例,行彩色多普勒成像,9例表现为2或3级血流,1例为点状血流。行乳腺MRI检查8例,表现为长T2信号6例,稍长T2信号2例,8例均表现为扩散加权成像(DWI)高信号。术后病理结果示11例为ER、PR、HER2均为阴性的三阴性乳腺癌,1例为ER阴性,PR、HER2阳性。结论乳腺原发性鳞状细胞癌在影像学上多具有典型的恶性征象,但较非特殊类型乳腺癌无明显特征性表现,病理结果大多为三阴性乳腺癌,具有特征性。

Objective To analyze the imaging features and clinical and histopathological features of primary squamous cell carcinoma of the breast. Methods Retrospective analysis was performed on 12 patients with primary squamous cell carcinoma of the breast admitted to our hospital from May, 2012 to February, 2020 and confirmed by biopsy or surgical pathology.All patients were examined by mammography, ultrasound or MRI within 1 week after admission, and complete imaging and clinicopathological data were obtained. Results 7 cases were located in the right breast and 5 in the left breast.Mammography was performed in 12 cases, showing simple mass in 9 cases, mass with calcification in 3 cases, high density in 10 cases and isodensity in 2 cases.There were 2 cases of marginal burr, 3 cases of marginal lobulation, 1 case of local occlusion, and 6 cases of fuzzy edges.The mean size of the primary lesion was(30.5±16.5)mm.Ultrasonography of breast was performed in 10 cases, and the ultrasonography of primary focus showed heterogeneous hypoecho in 7 cases, cystic solid echo in 3 cases, color doppler imaging showed grade 2 or 3 blood flow in 9 cases, and punctate blood flow in 1 case.Breast MRI examination was performed in 8 cases, showing long T2 signal intensity in 6 cases, slightly long T2 signal intensity in 2 cases, and high DWI signal intensity in all 8 cases.Postoperative pathological results showed that 11 cases were triple negative breast cancer with negative ER,PR and HER2,and 1 case was ER negative, PR and HER2 positive. Conclusion Primary squamous cell carcinoma of breast has typical malignant signs on imaging, but has no obvious characteristic manifestations compared with non-special type of breast cancer.The pathological results are mostly triple negative breast cancer with characteristic features.