乳腺管状腺瘤声像图特点及与病理对照分析

目的 探讨乳腺管状腺瘤的超声特点,并与病理进行对照。方法 回顾性分析17例乳腺管状腺瘤（21个病灶）的超声及病理图像,总结其超声特点及相关病理联系。结果 病灶大部分呈低回声（19/21,90.48%）,边界清晰（18/21,85.71%）,类似典型纤维腺瘤。17个病灶（17/21,80.95%）无侧方声影,提示无明确包膜。7个病灶呈分叶状（7/21,33.33%）,7个病灶（7/21,33.33%）边缘呈微小"分支状"与周边腺体内导管相延续,8个病灶（8/21,38.10%）表现为内部回声不均。彩色多普勒示5个病灶（5/21,23.81%）内无血流信号,16个病灶（16/21,76.19%）内可见血流信号,其中4个病灶（4/21,19.05%）血流信号丰富。病理示所有病灶均无明显包膜,致密增生的小腺管成分≥70%;4个病灶内血管密度较高,部分呈粗大裂隙样静脉结构;2个病灶内可见不规则钙化,2个病灶内可见玻璃样变及胶原沉积。结论 乳腺管状腺瘤超声图像具有一定特征,并与病理改变密切相关,仔细分析图像有助于进行鉴别并提高术前诊断率。

Comparative analysis of ultrasonography and clinicopathology in diagnosis of tubular adenoma of breast

Objective To investigate ultrasonic features of tubular adenoma of breast, and to compare with clinicopathological findings. Methods Totally 17 patients with histologically proved tubular adenomas (21 lesions) were enrolled. The ultrasonic and clinicopathological features of the lesions were evaluated, and the relationship between ultrasonic and pathological features were observed. Results The majority of tubular adenomas shared common performances as fibroadenoma on ultrasonography, such as hypoechoic (19/21, 90.48%) and well defined margins (18/21, 85.71%). Among 21 lesions, 17 lesions (17/21, 80.95%) showed no lateral wall shadowing, 7 lesions (7/21, 33.33%) showed macro-lobulations, 7 lesions (7/21, 33.33%) showed continuity with surrounding duct, and 8 lesions (8/21, 38.10%) represented heterogeneous in texture. Blood flow was demonstrated in 16 lesions (16/21, 76.19%), and rich blood flow was seen in 4 lesions (4/21, 19.05%). Histopathologic examinations showed all lesions were sharply demarcated from adjacent breast tissue without true fibrovascular capsule. The lesions were consisted of small tubular structures occupied more than 70% of tumor area. Large crack-like vein structures were seen in 4 lesions. Irregular calcifications were found in 2 lesions. Hyaline degeneration and collagen deposit were found in 2 lesions. Conclusion Ultrasonic features of breast tubular adenoma are closely related with pathological changes. Careful and comprehensive ultrasonic analysis may be helpful to preoperative differential diagnosis.