乳腺叶状瘤的X线表现与病理特征

The radiological appearances and pathological features of phyllodes tumor of the breast

目的 探讨乳腺叶状瘤 (phyllodestumor,PT)的X线表现与病理特征 ,以期从影像学角度提高对该病的认识。方法 回顾性分析 13例经病理证实的PTX线表现与病理。结果 13例PT中9例肿块表现为圆形、边缘光整有“透明晕”(病理上有完整“包膜”) ,6例为低度恶性 ,3例为中度恶性。 4例肿块部分界限模糊 (病理上 3例呈浸润性生长 ,“包膜”不完整 ) ,3例为中、高度恶性 ,1例为低度恶性。肿瘤直径 <5 0cm的 8例中 ,中、高度恶性 5例 ;肿瘤直径 5 0～ 10 0cm的 5例中 ,低度恶性4例。结论 中年妇女乳房内肿块大而周边有“透明晕”是PT较特征的X线征象 ,近期迅速增大有助于诊断。PTX线表现与组织学分级有一定关系 ,边界不清楚提示恶性程度较高 。

Objective To study the radiological appearances and pathological features and enhance the knowledge of phyllodes tumor (PT) of the breast. Methods The radiological appearances and pathological features of 13 patients with pathologically proved PT were analyzed retrospectively. Both radiological findings and pathological classification were conducted with double blind method. Results The radiological findings in 13 PT patients were circular, often with lobulated borders. In 9 cases, the tumors were with smooth borders and were surrounded by a clear halo(complete capsule could been seen in pathology), of them 6 were low grade and 3 were middle grade. In 4 cases, part of tumor margin was poorly defined ( part of tumor infitrated growth could been seen in pathology in 3 cases), of them 3 were middle or high grade malignancy, 1 was low grade. In 8 cases with tumor measured less than 5 cm in diameter, middle and high grade malignancy was seen in 5 cases. In 5 cases tumors measured 5.0-10.0 cm in diameter, low grade malignancy was seen in 4 cases. Conclusion A loblated large mass in the breast with a clear halo was the features of PT, but it had no characteristics,In middle-aged women, the mass with rapid growth help establish the diagnosis. The radiological appearances of the tumor appear to be related to its pathological classification, an unclear borderline of the tumor may indicate a high degree of malignancy, but the sign is unreliable. Size of the tumor does not appear to be related to its pathological classification. The diagnosis still depends on the histopathological examination.