Sonographic features of breast hamartomas

The sonographic features of ten breast hamartomas are reported. Four masses were clinically palpable. The mammographic appearance was characteristic of hamartomas in five cases. In the remaining five lesions, because the radiographic appearance was not pathognomonic, surgical excision was required for pathologic confirmation of the diagnosis. A wide spectrum of sonographic appearances was identified, the most frequent was that of a moderate to well-circumscribed, solid, hypoechoic mass with posterior acoustic shadowing. Two isoechoic hamartomas were very difficult to visualize on sonography. We conclude that ultrasound has a minimal role in the diagnosis of breast hamartomas, in view of their wide sonographic variability.     

血供丰富的肾错构瘤的螺旋CT表现与临床

目的探讨血供丰富的肾错构瘤的螺旋CT表现及治疗。方法回顾性分析12例经手术病理证实的多血供肾错构瘤的螺旋CT表现及治疗方法，并与病理进行对照研究。结果12例中，4例CT片上看不到脂肪密度，8例可见到散在小斑块状脂肪密度。增强扫描全部肿瘤于肾皮质期明显强化，肾实质期肿瘤强化减退。12例均行手术切除，其中9例行肿瘤剜除术，3例因瘤体大、严重累及肾实质和肾窦而行一侧肾切除术。结论血供丰富的肾错构瘤螺旋CT增强扫描往往表现为快进快出这种一过性明显强化方式，当瘤内看不到脂肪密度时应注意与多血供肾癌鉴别。由于血供丰富的肾错构瘤生长快且易破裂出血，所以当影像发现肾错构瘤供血丰富时，即使瘤体小、无症状．亦应建议临床及早手术切除．     

乳腺错构瘤的X线诊断(附20例报告)

目的：分析乳腺错构瘤的X线征象，以提高对其影像诊断水平。材料与方法：回顾性分析20例经病理证实的乳腺错构瘤的X线平片。结果：主要X线征：（1）低密度肿块5例。（2）高密度肿块3例。（3）混杂密度肿块10例。（4）未见肿块2例。结论：乳腺错构瘤的X线表现与其病灶内低密度的脂肪组织及高密度的腺体组织，纤维组织所占的比例有关，其中混杂密度是特异性的X线表现。     

Breast hamartoma: ultrasound,elastosonographic, and mammographic features. Mini pictorial essay

Hamartomas, also known as fibroadenolipomas, are rare, benign formations that can develop in various organs, including the breast. They present clinically as a soft, mobile nodular lesions and are generally asymptomatic. They may be discovered incidentally during imaging studies performed for other reasons. Owing to the increasingly widespread use of mammographic screening, the diagnosis of breast hamartomas is on the rise. The masses are associated with specific mammographic and sonographic features that reflect their diverse tissue components. They also appear to present reproducible features on elastography. This article reviews the typical features of breast hamartomas seen on these three imaging modalities.     

乳腺错构瘤的超声与病理表现对照观察

目的探讨乳腺错构瘤的超声表现及其病理基础。方法回顾分析病理证实的23例乳腺错构瘤的超声图像与病理表现。结果所有病灶呈圆形或椭圆形,边界清楚,可见包膜,无后方回声衰减;内部回声因瘤体内所含脂肪和纤维腺体成分的数量不同而异,可分为3型:脂肪为主型、纤维(纤维腺体)为主型和脂肪纤维混合型。结论混杂回声及完整包膜是乳腺错构瘤的特征性表现。超声可清晰显示脂肪和纤维腺体成分分布的区域,切面形成特征性"香肠切片"样征象。     

乳腺错构瘤的X线诊断 (附8例报告)

目的：探讨对乳腺错构瘤的X线诊断与鉴别诊断。材料与方法：对8例经手术病理证实的乳腺错构瘤进行回顾性X线分析。结果：密度不均,瘤体内脂肪和纤维腺体等量分布,形成“水中浮岛”,是乳腺错构瘤最典型的一种类型,易于确诊,本组3例确诊为错构瘤。对于密度尚均匀,不典型的乳腺错构瘤,如以脂肪为主密度较低者,易误为脂肪瘤或囊肿,本组2例。如以纤维腺体为主,密度较高者,易误为纤维腺瘤,本组1例。伴边缘不清,则可疑恶变,本组1例。另1例属错构瘤早期改变。结论：X线分型对于不同类型乳腺错构瘤的X线诊断具有较高价值。     

Thrombocytopenia caused by splenic hamartoma: resolution after splenectomy

We report a rare case of isolated thrombocytopenia due to a large hamartoma of the pulposal type, which resolved with splenectomy in a 46-year-old man. Although hamartomas are usually found incidentally, they may cause hematologic disturbances such as thrombocytopenia, anemia, or splenic rupture. The diagnosis of splenic hamartoma is difficult to make preoperatively. Splenectomy is important in excluding malignant tumors from the diagnosis when the etiology of a splenic mass is unclear and ameliorating hematologic symptoms related to hamartomas.     

Sonographic features of breast hamartomas.

OBJECTIVE: The purpose of this study was to elucidate the sonographic characteristics of breast hamartomas. METHODS: Data and sonographic images of 14 breast hamartomas were retrospectively reviewed. RESULTS: All patients had clinically palpable lumps. The median patient age was 39.5 years (range, 24-60 years). Eleven (78.6%) tumors occurred in the right breast, and 3 (21.4%) were in the left. The median tumor size measured by sonography was 2.8 cm (range, 1.2-4.9 cm). The median longest transverse dimension-anteroposterior diameter ratio of the tumors was 2.44 (range, 1.52-3.73). All tumors were oval and compressible with transducer pressure. Thirteen (92.9%) tumors were well circumscribed with smooth tumor margins, and 1 (7.1%) had indistinct margins. The internal echo texture was hyperechoic in 6 (42.9%), mixed (heterogeneous) echogenicity in 5 (35.7%), and isoechoic in 3 (21.4%). Four (28.6%) tumors had echogenic halos, and 2 (14.3%) had anechoic halos. Ten (71.4%) tumors had no retrotumor acoustic phenomena. Two (14.3%) had bilateral edge shadowing; 1 (7.1%) had posterior enhancement; and 1 (7.1%) had a mixture of enhancement and shadowing. CONCLUSIONS: Breast hamartomas were well-circumscribed, solid, oval tumors without intratumor microcalcification. The internal echo texture of most hamartomas is either hyperechoic or composed of mixed echogenicity. Retrotumor acoustic phenomena were absent in most hamartomas.     

Extensive multiple hamartomas of the lung of the diffuse juvenile type

The case report of a 12 year-old female patient suffering from extensive multiple hamartomas of the left lung (diffuse juvenile type) is presented. The clinical features were atypical due to the large size of the tumour. The entire left lung and parts of the pleura and pericardium were involved. The diagnosis was reached only after histological examination of the operation specimen, as is usual with intrapulmonary hamartomas of the lung.     

腹部超声检查在诊断结节性硬化症中的应用价值

目的：探讨腹部超声在结节性硬化症诊断和随访中的价值。方法：分析112例结节性硬化症患者的腹部超声表现,对病变的特点进行总结。结果：112例结节性硬化症患者中B超发现65例（58.0%）有肾脏病变,累及双肾46例,累及单侧肾脏19例;肾脏错构瘤54例,多发47例,单发7例;肾囊肿20例,其中12例伴发肾脏错构瘤;肾脏多发钙化灶6例,其中3例和肾囊肿或肾脏错构瘤并发。15岁以上的年龄组肾脏病变的发生率（69.1%）高于15岁以下年龄组（47.4%）（P〈0.05）。肾脏错构瘤会随着年龄增长而增大。23例（20.5%）有肝脏病变,其中21例（91.4%）伴有肾脏病变,肝脏多发结节12例,单发结节11例。结论：腹部超声有助于结节性硬化症的诊断,是结节性硬化症肝肾病变的重要的影像学检查和随访方法。     

Testicular hamartomas in Cowden disease

We report a case of testicular hamartomas in association with Cowden disease. Clinical examination of the patient, a 39-year-old man, revealed a palpable mass in the right side of the scrotum. Sonographic examination showed that the mass was either a spermatocele or an epididymal cyst and that multiple hyperechoic lesions were present in both testes. On subsequent MRI, the appearance of these lesions was consistent with that of fat-containing hamartomas. Testicular biopsy was not performed, but follow-up serial sonographic examination was recommended. To our knowledge, this report is the first to describe testicular hamartomas as a probable manifestation of Cowden disease.     

儿童肝脏间叶错构瘤超声表现

目的总结儿童肝脏间叶错构瘤超声表现.方法 回顾性分析2005年1月至2011年5月在我院行超声检查并经手术及病理证实的11例肝脏间叶错构瘤患儿超声声像图特点.结果11例肝脏间叶错构瘤患儿中超声检查呈囊实性表现9例,其中多房囊腔7例,单房囊腔2例;7例多房囊腔中,4例囊腔呈蜂窝状并囊间隔薄厚不均,3例囊腔不规则并囊内丝网状分隔,囊腔周边见中等回声实性区环绕或局限分布.2例单房囊腔中,1例表现为厚壁囊腔,另1例表现为较大实性中等回声肿块内一单房囊腔,囊腔体积仅占肿块的4%.本组2例患儿超声检查瘤体表现为低回声实性肿块.结论 儿童肝脏间叶错构瘤超声声像图特点鲜明.超声检查可作为本病首选的检查方法.对于2岁以内的婴幼儿,肝脏肿瘤超声检查表现为囊实性或囊性为主,应首先考虑肝脏间叶错构瘤.     

不同检查方法对乳腺错构瘤的诊断价值(附11例报告)

目的:探讨乳腺错构瘤的临床、病理及钼靶X线表现特点,以提高其临床诊断率。方法:分析1996~2006年我院经术后病理诊断的11例乳腺错构瘤的临床资料,比较临床、影像学与病理诊断符合率。结果:本组2例术前分别经临床诊断和钼靶X线检查确诊,术前诊断与病理诊断符合率为18.2%,术中均行冷冻切片病理检查,9例诊断正确,与术后石蜡切片病理,诊断符合率为81.8%。结论:钼靶X线检查可提高乳腺错构瘤的诊断率,术中行冷冻切片病理检查对乳腺错构瘤诊断准确率较高,有助于合理选择手术方式。     

The mammary hamartoma: appreciation of additional imaging characteristics.

OBJECTIVE: To determine the mammographic and sonographic findings of hamartomas that were not classic on imaging, how pathologists distinguish the hamartoma from benign breast tissue on core samples, and reasons for discrepancies between core and surgical biopsy. METHODS: A retrospective review of all image-recommended core biopsies between 1993 and 2001 was performed. There were 41 cases of hamartomas found on either core or surgical biopsy. The mammographic, sonographic, and pathologic findings were reviewed. RESULTS: Of 41 hamartomas in 38 patients, 18 went on to surgical biopsy. Of these 18 cases, 4 cases of hamartoma on core biopsy were fibroadenoma after excision; 2 cases of hamartoma on core biopsy were confirmed by surgery; and 12 cases of fibrocystic change after core biopsy were hamartoma after surgical biopsy. The 4 cases of fibroadenoma shown at final pathologic examination were excluded from imaging review, leaving 37 cases. In the 20 patients who underwent only core sampling, 23 hamartomas were diagnosed. Seventeen masses were visible on mammography, and 82% were homogeneously dense. Of 36 masses shown on sonography, 86% were uniformly hypoechoic. At histologic examination, only 16% contained fat within the mass. CONCLUSIONS: Hamartomas may appear as homogeneously dense, well-circumscribed masses, varying in appearance from the classically described encapsulated mixed fatty-fibroglandular mass. Pathologists can make the diagnosis of hamartoma without the presence of adipose tissue but may have difficulty in distinguishing the hamartoma from fibrocystic change. However, if there is radiologic-pathologic concordance, further surgical excision is not warranted.     

肺内良性结节性病变影像学误诊原因分析

目的 为了探讨肺内良性结节性病变影像学诊断中误诊原因。方法 回顾性分析28例肺内良性结节性病变的影像学资料、X线平片加体层摄影11例。CT平扫检查17例,其中8例采用增强扫描检查。结果 20例误诊为肺癌,余8例中定性有误,其中错构瘤误诊为炎性假瘤6例,炎性假瘤误诊为结核球1例,错构瘤1例。结论 重现临床病史,合理使用影像学检查方法,提高增强CT扫描检查的认识,加强影像学表现综合分析,是减少误诊的关键。     

肺错构瘤的螺旋CT诊断

目的:探讨肺错构瘤的螺旋CT特点,提高肺错构瘤的影像学诊断和鉴别诊断的正确性。方法:回顾性分析33例经手术病理证实的肺错构瘤患者的临床资料及螺旋CT图像。结果:本组肺错构瘤均为单发,左肺21例,右肺11例,位于下叶的共有23例,占69.7%(23/33)。本组肺错构瘤多位于胸膜(包括叶间胸膜)附近,瘤体与胸膜的平均距离是0.6cm。本组肺错构瘤的瘤体直径在0.8~2.7cm,瘤体平均直径1.8cm。本组肺错构瘤的瘤体边缘均清晰锐利,无毛刺。本组瘤体中观察到不同形态钙化影的有18例,占54.5%(18/33);观察到脂肪影的有7例,占21.2%(7/33);层厚1~2mm扫描时观察到的钙化影及脂肪影多于层厚5mm扫描时。利用螺旋CT的三维重建技术进行后处理,本组中观察到瘤体周围肺纹理走行自然、分布正常的有20例,占60.6%(20/33);观察到瘤体周围肺纹理轻度受压并呈握球状的有13例,占39.4%(13/33);全部病例均未观察到周围肺纹理的增粗、聚拢、牵拉等支气管血管集束征。结论:肺错构瘤具有明显的螺旋CT特点。螺旋CT薄层扫描和三维重建技术在肺错构瘤的诊断和鉴别诊断中具有重要的价值。     

Tailgut cyst: 2 case reports

Tailgut cysts, or retrorectal cystic hamartomas, are rare congenital developmental lesions. It is a benign lesion, but there is a risk of degeneration, so surgical resection is necessary.     

Endoscopic findings in Cowden syndrome

Cowden syndrome is characterized by diffuse hamartomas involving the whole digestive tract. The gastrointestinal expression of the disease is inconstant, but hamartomatous polyposes are frequent. In a multicenter study we studied the endoscopic appearance of Cowden syndrome--as defined by fulfillment of international consortium criteria--in 10 patients. In 6 of the 10 patients the connection with Cowden syndrome was made retrospectively on the basis of the gastrointestinal endoscopic findings. All patients had upper and lower gastrointestinal tract involvement. Mean follow-up duration was 9.5 years (range: 2-26 years). Mean age was 37 years (range: 18-56 years). Polyps of the upper gastrointestinal tract were hamartomas, ganglioneuromas, lipomas, and adenomas. Diffuse glycogenic acanthosis was reported in nine patients. Besides the classical hamartomatous polyposis, diffuse macroscopic esophageal acanthosis and microscopic ganglioneuromatosis are other key findings associated with a diagnosis of Cowden syndrome. Physicians should be aware of these characteristics in order to diagnose Cowden syndrome early.     

下丘脑错构瘤的CT、MR检查

目的：探讨CT、MR诊断下丘脑神经元错构瘤的临床意义。方法：比较分析了9例经手术证实的下丘脑神经元错构瘤的影像学表现，同时复习了一些相关献。结果：病变均位于鞍上池及脚间池内，形态呈类圆形、受压类圆形、不规则形。病灶在CT图像上呈等密度或略低密度。MRT1WI表现为低或略低信号影；T2WI呈高或稍高信号影。增强检查病灶可无强化表现。病灶以宽基底及窄基底上附于第3脑室底部、灰结节和乳头体。结论：下丘脑错构瘤的诊断主要依据临床表现和影像学征象。在诊断时应与其他鞍区病变进行鉴别。     

Demyelination of the brain in tuberous sclerosis: computed tomography evidence.

Two patients with tuberous sclerosis are described in whom computed tomography of the head revealed areas of diffuse diminution of density suggestive of demyelination. Computed tomography is a sensitive test for the detection of intracerebral lesions in tuberous sclerosis, and the finding of areas of diminished density in the absence of evidence for tumor or ventricular obstruction correlates with the common histologic finding of diffuse demyelination. Serial studies with computed tomography are likely to determine whether such demyelination precedes the growth of hamartomas and calcification that characterize tuberous sclerosis.