乳腺颗粒细胞瘤的影像学表现及临床病理学特征分析

Analysis of imaging and clinicopathological features of granular cell tumor of the breast

目的:分析乳腺颗粒细胞瘤(granular cell tumor of the breast,GCT-B)的影像学表现,结合其临床表现及病理学特征,提高对该病的认识及鉴别诊断能力。方法:回顾并分析2017年3月—2022年12月于复旦大学附属肿瘤医院经手术后病理学检查证实的11例GCT-B的数字化乳腺X线摄影(digital mammography,DM)、乳腺磁共振成像(magnetic resonance imaging,MRI)及临床病理学资料。其中,10例行DM检查,6例行乳腺MRI平扫及动态增强检查。结果:11例患者中男性1例,女性10例,发病年龄20~66岁,中位年龄35岁,以绝经前女性多见(8例),多为偶然发现(10例)。病灶皆表现为单发小肿块,直径14~17 mm,多位于乳房上象限(10例)。病灶在DM上形态各异,部分边缘见毛刺(5例),均未伴有钙化。MRI平扫肿块信号多变,动态增强呈早期快速强化,晚期强化持续或增强。病理组织学检查11例S-100均为阳性,10例SOX-10阳性,8例CD68阳性,Ki-67增殖指数均低于10%。随访4~70个月,均无复发。结论:GCT-B是一种乳腺罕见肿瘤,好发于乳腺上部,临床上多偶然发现,多发生于绝经前女性。DM上呈不伴钙化的肿块,MRI动态增强表现为早期快速强化,对临床诊断具有一定价值。

Objective:To analyze the imaging features of granular cell tumor of the breast(GCT-B),as well as clinicopathological characteristics,in order to improve the understanding and the ability of differential diagnosis of GCB-T for clinicians.Methods:Imaging findings on digital mammograph(DM)and magnetic resonance imaging(MRI),clinical presentations,pathological and immunohistochemical examinations of 11 cases of GCT-B confirmed by pathology in Fudan University Shanghai Cancer Center from March 2017 to October 2022 were retrospectively analyzed,including 10 cases of DM,6 cases of MRI.Results:In the 11 GCT-B cases,1 was male and 10 were female,the age of onset ranged from 20 to 66 years,with a median age of 35 years,more frequently in were premenopausal women(8 cases),mostly found by accident(10 cases).The lesions were all solitary small mass,with a diameter range from 14 to 17 mm,mostly located in the upper quadrants of the breast(10 cases).The lesions have different shapes on DM,5 cases with spiculate boundary,none with calcification.On MRI plain scan,the signal of the tumor is variable.After dynamic enhancement,all mases showed rapid enhanced in early-phase,with persistent or enhanced enhancement in delay-phase.11 cases with S-100 positivity,10 cases with SOX-10 positivity,8 cases with CD68 positivity,Ki-67 proliferative indexs were less than 10%.There was no recurrence during 4 to 70 month follow-up.Conclusion:GCT-B is a rare tumor of the breast,which usually occurs in the upper part of the breast and was more common in premenopausal women.GCT-B presents as solitary mass on DM,usually without calcification,and shows rapid mass-like enhancement in early phase on dynamic enhanced MRI,which are of significance for clinical diagnosis.