乳腺浸润性微乳头状癌超声表现

目的:探讨乳腺浸润性微乳头状癌超声声像图的特点。方法:回顾分析10例经病理证实的乳腺浸润性微乳头癌的超声图像资料。结果:10例乳腺浸润性微乳头状癌的最大径为15～44 mm,平均28 mm;其超声表现呈不规则形(90%)或卵圆形(10%);边界模糊(80%)或清晰(20%);10例肿块内均为不均质低或稍低回声,60%瘤内见微小钙化灶;血供中等(80%)或少量(20%),阻力指数0.62～0.77,平均0.71;超声弹性成像中3个(50%)肿块评分为4分,3个(50%)肿块评分为2～3分。80%病灶超声诊断为乳腺恶性肿瘤,20%被误诊为乳腺病。超声诊断同侧腋窝淋巴结癌转移的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为100%、83%、80%、100%和90%。结论:乳腺浸润性微乳头状癌的典型超声表现为形态不规则、边界模糊、不均匀低或稍低回声。浸润性微乳头状癌不伴钙化时容易被误诊为乳腺病。超声对腋窝淋巴结癌转移的诊断有较高价值。

Sonographic Features of Invasive Micropapillary Carcinoma of the Breast

Abstract Objective：To investigate the sonograghic features of invasive micropapillary carcinoma. Methods： Ten cases of his- tologically proved invasive micropapillary carcinoma were reviewed. Results： The mean longest diameter of the ten cases of mi- cropapillary carcinoma was 28 mm （range, 15-44 mm）. The tumor shapes were irregular（90%） or oval（10%）. The tumor margins were indistinct（80%） and distinct （20%）. The internal echoes were hypoechoie or slightly hypoeehoic and were inho- mogeneous in all tumors. Microealcifications were visible in six tumors. Moderate vaseularity were seen in eight tumors and mild vascularity in the other two tumors. The resistive index was 0. 62-0. 77（average 0.71）. On elastography, three（50%） le- sions had a score of four, and three （50%） lesions had a score of one to three. Eight masses were diagnosed as malignant tumor and two masses were misdiagnosed as mastopathy. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of axilary nodal sonography in the detection of metastasis were 100%, 830%, 80%, 100% and 90%, re- spectively. Conclusions： The typical sonographic feature of invasive micropapillary carcinoma is an irregularly shaped hypoeeho- ic or slightly hypoechoic mass with indistinct margins. It can be misdiagnosed as mastopathy when a tumor has no microcalcifi- cations. Ultrasound is of great value for the detection of axillary nodal metastasis.