Lipomatous tumors of the stomach: CT findings and differential diagnosis

This article reviews the computed tomography imaging features of a variety of gastric tumors containing fatty tissue. Lipoma, angiolipoma, liposarcoma, and teratoma are described. Differential diagnosis includes primary and reactive lipomatosis, carcinoma engulfing the perivisceral fat thus mimicking differentiated liposarcoma, and mesenchymal gastric and peritoneal neoplasms.     

乳腺叶状瘤的影像诊断

目的 总结分析乳腺叶状瘤X线钼靶照片和超声检查的影像学特征。方法 搜集1991年1月至2003年5月经手术、病理证实的25例乳腺叶状瘤，其中13例行X线钼靶摄片，17例行超声检查，回顾性分析其临床特点及影像学征象。结果 25例乳腺叶状瘤中病理诊断Ⅰ级者17例，Ⅱ级7例，Ⅲ级1例。13例行乳腺X线钼靶检查患者病灶表现为圆形(7例)或浅分叶状(6例)密度高于邻近腺体的肿块，边界清楚(8例)或部分不清(5例)，所有病例均未发现钙化及邻近皮肤增厚、乳头回缩、周围乳腺结构扭曲等恶性征象。行乳腺超声检查的17例患者，病灶表现为低回声者16例，边界规整者16例，出现囊变者10例，11例出现后方回声增强。结论 乳腺叶状瘤的影像学表现有一定的特点，但这些表现为非特征性，与纤维腺瘤等边界清楚的实性病灶的鉴别有一定的困难，对可疑病灶行切除活检非常必要。     

Calcified pilomatrixoma of the breast: mammographic and sonographic findings

The authors report the ultrasonographic and mammographic features of a case of pilomatrixoma of the breast, a rare benign neoplasm originating from the hair matrix.     

Benign papillary neoplasms of the breast: mammographic findings

The clinical presentation, pathologic characteristics, and mammographic/ductographic (also known as galactographic) findings were reviewed in 77 patients with histologically proved benign papillary neoplasms of the breast. Patients were classified as having either solitary or multiple papillomas. Patients with multiple papillomas were further subclassified as having either central or peripheral papillomas. Fifty-one patients (66%) had solitary papillomas. Thirty-seven of these patients were symptomatic; 36 had spontaneous nipple discharge, and one had a palpable mass. Ductography was positive in 32 of the 35 patients who underwent the procedure. In the 14 asymptomatic patients, subareolar (n = 10) and peripheral (n = 4) mammographic abnormalities prompted biopsy. Fourteen patients (18%) had multiple peripheral papillomas, and one patient also had bilateral central solitary papillomas. Eleven of these patients were asymptomatic, while two presented with palpable abnormalities and one with spontaneous bilateral discharge. Mammographic findings included microcalcifications (n = 5) and clustering nodules (n = 2). Associated atypical ductal hyperplasia was found in six (43%) of the 14 patients with multiple peripheral papillomas. Some of these patients also had lobular carcinoma in situ and radical scars. Twelve patients had multiple central papillomas; all presented with spontaneous nipple discharge and had positive ductograms.     

Mondor's disease of the breast: sonographic and mammographic findings

OBJECTIVE: The purpose of this study was to evaluate the mammographic and sonographic findings in patients with Mondor's disease of the breast. CONCLUSION: The combination of a sonographic finding of a superficial vessel-with or without an intraluminal thrombus and without flow on Doppler imaging-and a mammographic finding of a tubular density is the typical sign of Mondor's disease of the breast. Women present with a palpable cordlike structure, which is often painful, especially in the acute phase of thrombophlebitis. An understanding of such an entity and knowledge of the imaging findings will help breast imagers avoid the pitfall of mistaking this finding for a dilated duct.     

Abnormalities of the breast caused by biopsy: spectrum of mammographic findings

It is important for radiologists to be familiar with the spectrum of mammographic abnormalities caused by postbiopsy changes in the breast. Although many breast biopsies leave no residual abnormality, occasionally an atypical manifestation of a biopsy scar may produce a radiologic finding suspicious enough to mandate a biopsy. Problem-solving maneuvers recommended to increase confidence that a change is related to a recent biopsy include (1) skin markers; (2) comparison with preoperative films; (3) correlation with physical examination; (4) tailored mammographic views, including focal spot compression, magnification, and tangential views; and (5) postoperative and follow-up mammograms.     

Ruptured breast implant: computed tomographic and mammographic findings

We report the computed tomographic and mammographic findings in a patient with a ruptured breast implant. The diagnosis was made by recognition of alteration in prosthesis contour, collapse of the prosthesis envelope, and the presence of free silicone in the breast and axillary region.     

Primary squamous cell carcinoma of the breast: mammographic findings

Primary squamous cell carcinoma of the breast is a rare lesion. Mammographic findings usually suggest malignancy and include an irregular, lobulated mass with poorly defined borders. Microcalcification is not a prominent finding. Tumor size is important in determining long-term outcome, and patients usually die from distant metastases.     

Tubulolobular carcinoma of the breast: Clinical,mammographic and sonographic findings

PurposeTo determine and quantitate radiologic characteristics of tubulolobular carcinoma of the breast and to report clinical and pathologic findings.Materials and methodsA retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 26 histopathologically proven tubulolobular carcinoma of the breast. Analysis included history; findings at physical examination, mammography, and sonography (US) at the time of diagnosis and in postoperative follow-up, and histopathological results.ResultsAt physical examination, palpable mass was present in 85% (n = 22) of the patients. The mammographic findings were mass in 17 (65%), asymmetric focal density in 2 (8%), architectural distortion in 2 (8%) and negative mammograms in 5 (19%) of the 26 patients. US depicted 25 masses in 24 patients, all of which were hypoechoic, with spiculated (n = 13) or microlobulated (n = 12) margins. The cancer was clinically occult in 12% (n = 3), mammographically occult in 19% (n = 5), and radiologically occult in 4% (n = 1) of the patients. Histologically, the mean size of the tumor was 1.7 cm and 18 (69%) patients were node negative.ConclusionTubulolobular carcinoma of the breast usually manifests clinically as a firm, immobile mass and mammographically as a spiculated or ill-defined, irregular, isodense mass without microcalcifications. Common findings on sonography include a homogeneously hypoechoic, spiculated or microlobulated mass with posterior acoustic shadowing or normal acoustic transmission. Tubulolobular carcinoma should be included in the differential diagnosis for breast masses with these imaging features.     

Fibrosarcoma of the breast: mammographic findings in five cases.

The mammographic features of fibrosarcoma of the breast, a rare malignant tumor, have not been described. Accordingly, we reviewed the mammograms, pathology reports, and medical records of five women with this tumor. All cases had surgical biopsies and a diagnosis made by histologic evaluation. The age of the patients ranged from 48 to 79 years. Histologically, three of the five fibrosarcomas were thought to have arisen from phyllodes tumor, and four were palpable. On mammograms, the tumors were dense masses with largely indistinct margins, ranging from 1.5 to 7.0 cm in diameter. One contained calcified osseous elements suggesting osseous trabeculae. Although the osseous trabeculae in that tumor strongly suggested sarcoma, most of the tumors had a nonspecific appearance on mammograms. Fibrosarcomas of the breast have a nonspecific mammographic appearance. Surgical biopsy and histologic evaluation are necessary for definitive diagnosis.     

Tubulolobular carcinoma of the breast: clinical, mammographic and sonographic findings

PURPOSE: To determine and quantitate radiologic characteristics of tubulolobular carcinoma of the breast and to report clinical and pathologic findings. MATERIALS AND METHODS: A retrospective review of records of 2872 women who received a diagnosis of breast carcinoma between January 1988 and January 2006 revealed 26 histopathologically proven tubulolobular carcinoma of the breast. Analysis included history; findings at physical examination, mammography, and sonography (US) at the time of diagnosis and in postoperative follow-up, and histopathological results. RESULTS: At physical examination, palpable mass was present in 85% (n=22) of the patients. The mammographic findings were mass in 17 (65%), asymmetric focal density in 2 (8%), architectural distortion in 2 (8%) and negative mammograms in 5 (19%) of the 26 patients. US depicted 25 masses in 24 patients, all of which were hypoechoic, with spiculated (n=13) or microlobulated (n=12) margins. The cancer was clinically occult in 12% (n=3), mammographically occult in 19% (n=5), and radiologically occult in 4% (n=1) of the patients. Histologically, the mean size of the tumor was 1.7cm and 18 (69%) patients were node negative. CONCLUSION: Tubulolobular carcinoma of the breast usually manifests clinically as a firm, immobile mass and mammographically as a spiculated or ill-defined, irregular, isodense mass without microcalcifications. Common findings on sonography include a homogeneously hypoechoic, spiculated or microlobulated mass with posterior acoustic shadowing or normal acoustic transmission. Tubulolobular carcinoma should be included in the differential diagnosis for breast masses with these imaging features.     

Mucocelelike lesions of the breast: mammographic findings with pathologic correlation

OBJECTIVE: The purpose of this study was to review the imaging features of mucocelelike breast lesions, correlate the mammographic and pathologic findings, and determine recommendations for management. CONCLUSION: Mucocelelike lesions are more common than previously reported and are likely to exhibit indeterminate calcifications on mammography. Diagnosis is most often made with Mammotome biopsy. A large number of patients have associated atypia or carcinoma. For patients with purely benign histologic findings at Mammotome biopsy, optimal management should be excisional biopsy to exclude associated malignancy.     

Unusual mammographic and ultrasonographic findings in fibromatosis of the breast

Fibromatosis of the breast is an uncommon disease, most often appearing as an aggressive lesion mimicking carcinoma on mammography. We describe, in an asymptomatic 40-year-old woman, an unusual imaging appearance of fibromatosis of the breast mimicking a benign lesion at mammographic and sonographic studies.     

Primary inflammatory carcinoma of the breast: retrospective review of mammographic findings

OBJECTIVE: Our goal was to describe the mammographic characteristics of primary inflammatory carcinoma of the breast. MATERIALS AND METHODS: We identified the medical records of 43 women who participated in a chemotherapy protocol for primary inflammatory carcinoma of the breast between 1994 and 1997. Mammograms were available for review in 26 women (age range, 34-78 years; mean age, 56 years). Two radiologists independently reviewed the 26 mammograms obtained before patients underwent treatment. A third observer was the final arbiter when needed. RESULTS: Mammographic findings included skin thickening in 24 patients (92%), diffusely increased density in 21 patients (81%), trabecular thickening in 16 patients (62%), axillary lymphadenopathy in 15 patients (58%), architectural distortion or focal asymmetric density in 13 patients (50%), and nipple retraction in 10 patients (38%). Malignant-appearing calcifications were seen in six patients (23%), and a mass was seen in four patients (15%). CONCLUSION: Diffuse mammographic abnormalities such as skin thickening, increased density, trabecular thickening, and axillary lymphadenopathy are common at presentation in patients with primary inflammatory carcinoma of the breast. Mammographic masses and malignant-appearing calcifications are uncommon manifestations of this disease.     

不典型乳腺癌全数字化乳腺摄影X线表现规律探讨

目的 探讨不典型乳腺癌全数字化(FFDM)乳腺x线摄影表现规律.方法 从2003年4月至2007年7月对门诊及体检者中影像表现不典型的134例乳腺癌或癌前病变进行分析,探讨其FFDM影像表现规律.全部病例采用GE平板2000D全数字化乳腺摄影机检查,体位常规采用头尾位(CC位)、内外斜位(MLO位),必要时加摄侧位及局部点片.对临床未触及包块的乳腺癌均行术前定位.结果 (1)影像表现为边界光整的肿块以浸润性导管癌(22/106,20.8%)、黏液腺癌(8/10)及髓样癌(5/6)最多;边界光整的肿块表现随年龄的增加而增多,30～40岁年龄段占其病例总数的13.3%(4/30),81 和90岁的2例均为此类型;边界光整的肿块表现随病变局部腺体致密程度减少而增多,依次分别占各自病例总数的14.0%(12/86)、34.5%(10/29)、84.2%(16/19).(2)粗乱条索影、结构紊乱、结构紊乱伴条索影及伴片状高密度主要见于浸润性导管癌(65例),并主要见于30～40岁(22例)及41-50岁(34例)两个年龄段和病变局部为致密型的腺体组织(55例),其中粗乱条索影最多见于30～40岁,占其病例总数的33.3%(10/30).(3)全乳房密度增高伴皮下水肿及类肿块影主要见于浸润性导管癌(均为7/8)及41～50岁(5/8)年龄段;全乳房密度增高伴皮下水肿(8例)及未见异常表现(4例)仅见于致密型腺体.结论 不典型乳腺癌FFDM影像表现类型与乳腺癌的病理类型、患者的年龄及病变区腺体的致密度有关.     

Nonpalpable breast lesions: accuracy of prebiopsy mammographic diagnosis

Mammograms of 220 patients who underwent spot localization for removal of nonpalpable breast lesions were reviewed for accuracy of interpretation. Results of subsequent biopsy indicated malignancy in 77 cases. The interpretations of mammograms obtained before biopsy were incorrect in 71 cases (27 false-negative and 44 false-positive studies). Among the false-negative cases, 70% of the abnormalities were determined histologically to be noninfiltrative cancers. An aggressive screening program with preoperative localization and biopsy is needed in questionable cases, since mammographic signs of early or nonpalpable malignancy are often subtle and nonspecific.