乳腺假血管瘤样间质增生超声误诊分析

Ultrasonographic Misdiagnosis of Pseudoangiomatous Stromal Hyperplasia

目的探讨乳腺假血管瘤样间质增生超声表现,分析其误诊原因。方法回顾性分析2021年5月—2022年7月收治的误诊的乳腺假血管瘤样间质增生4例的临床资料。结果4例均以发现乳房肿块就诊,肿块均位于右侧乳腺,其中1例位于外上象限,2例位于内上象限,1例位于内下象限。4例超声首诊均误诊,2例误诊为纤维腺瘤,1例误诊为乳腺癌,1例误诊为乳腺囊肿。4例最终均行肿块完整切除手术,术后病理均证实为乳腺假血管瘤样间质增生。1例随访11个月复发,余3例随访无复发。结论乳腺假血管瘤样间质增生临床少见,临床特征不典型,极易误诊,超声科医师应仔细辨别,熟悉其超声特征,以减少误诊。

Objective To investigate the ultrasonographic features of pseudoangiomatous stromal hyperplasia of the breast(PASH)and to analyze the causes of misdiagnosis.Methods Retrospective analysis was performed on clinical data of 4 misdiagnosed patients with PASH admitted from May 2021 to July 2022.Results All 4 patients presented with breast mass,which was located in the right breast,including 1 patient in the upper outer quadrant,2 patients in the upper inner quadrant,and 1 patient in the lower inner quadrant.All 4 patients were misdiagnosed with the first ultrasound diagnosis,2 patients were misdiagnosed with fibroadenoma,1 patient was misdiagnosed with breast cancer,and 1 patient was misdiagnosed with breast cyst.All the 4 patients underwent complete resection of the mass and were pathologically confirmed to be PASH.One patient recurred at 11-months follow-up,and the other three patients reported no recurrence during follow-up.Conclusion PASH is rare in clinical practice,and its clinical symptoms and characteristics are not typical,which is prone to misdiagnosis.Ultrasound doctors should carefully distinguish and be familiar with its ultrasonic characteristics to reduce misdiagnosis.