乳腺叶状肿瘤的X线表现

目的探讨乳腺叶状肿瘤X线影像学特点,并与其病理对照,以提高对该病的诊断准确率。方法回顾性分析经手术病理证实有完整乳腺X线资料的乳腺叶状肿瘤50例共54个病灶,其中良性26个、交界性22个、恶性6个。结果 54个病灶中表现为伴或不伴钙化的肿块50个(92.6%),假阴性4个(7.4%)。50个肿块病变中良性23个、交界性21个、恶性6个。形状以分叶状、圆形或卵圆形最多见,分别占62.0%(31/50)、10.0%(5/50)、26.0%(13/50)。肿块边缘主要表现为清楚或部分清楚部分模糊,占80%(40/50),其余肿块呈浸润状及细小分叶状边缘,分别占18.0%(9/50)和2.0%(1/50)。肿块表现为高密度占74.0%(37/50),等密度占26.0%(13/50)。3个病灶肿块内含有钙化。边缘特征在良性与恶性肿瘤、交界性肿瘤与恶性肿瘤之间有明显差异,P_(良-恶)=0.003,P_(良-恶)=0.044。结论乳腺叶状肿瘤主要X线表现为分叶状或圆形、卵圆形的高密度肿块,钙化少见;边缘特征可在一定程度上提示良恶性叶状肿瘤的区别。

The mammographic features of phyllodes tumors of the breast

Objective To study the mammographic characteristics of breast phyllodes tumors and correlate them to the pathological features in order to enhance the recognition of the tumor. Methods Imaging findings were retrospectively reviewed in 50 cases with 54 phyllodes tumors confirmed by surgical pathology, including 26 benign, 22 borderline and 6 malignant tumors. Results Of the 54 lesions, 50 appeared as masses （92. 6% ） with or without calcification, and 4 le- sions were missed mammographically. 50 masses on mammography included 23 benign tumors, 21 borderline tumors and 6 malignant tumors, and most of them were lobulated （31/50, 62. 0%）, round （5/50, 10.0%） or oval （13/50, 26. 0% ）. Most masses showed circumscribed or partially obscured margins （40/50, 80. 0% ）, the others presented indis- tinct （9/50, 18.0% ） or microlobulated （ 1/50, 2. 0% ） margins. 37 masses were of high density and 13 were of isodensi- ty. Only 3 masses were associated with calcifications. The results showed significant differences in tumor＇s margins （ benign vs malignant phyllodes tumors, P = 0. 003, borderline vs malignant phyllodes tumors, P = 0. 044 ）. Conclusion On mammography most phyllodes tumors of the breast are high-density masses with lobulated, round or oval shape, and calcifi- cations are rare. The feature of margin may help differentiate benign and malignant phyllodes tumors.