乳腺病变钼靶X线误诊常见原因分析

目的 探讨乳腺疾病钼靶X线误诊的常见原因，尽量避免误、漏诊现象的发生。方法 收集2003年3月～2010年6月我院行钼靶x线检查诊断为良性病变、而临床病理检查为乳癌的23例病例及钼靶检查为恶性病变而病理诊断为良性病变（最终经上级医院病理证实为恶性病变）的3例病例做回顾性分析，所有病例均为女性，致密性腺体，年龄33～56岁。结果 14例小叶浸润癌误诊为小叶增生，表现为一侧乳腺小叶不对称性致密，结构紊乱；9例导管原位癌误诊为腺体囊性增生，表现为局限性腺体结构紊乱、致密，无明显钙化灶存在；2例钼靶X线提示小叶原位癌，病理误诊增生性病变，表现为微小肿块，周边有透亮水肿带；1例乳头状腺癌，病理误诊为内生乳头状瘤，表现为浅分叶肿块，周边明显透亮水肿带形成。结论 乳腺疾病的误漏诊时有发生，危害严重，其良、恶性肿瘤具有较为特征性的钼靶X线征象及体征，密切结合临床体检与钼靶X线征象综合分析，可明显减低误诊的发生率。

Analysis of Common Cause of Misdiagnosis on X-ray Mammography of Breast Lesions

Objective To explore the common cause of misdiagnosis on X-ray mammography of breast lesions for reducing the incidence of misdiagnosis. Methods Collected 23 cases of breast cancer by clinical and pathological examination but mammography X-ray diagnosis of benign lesions and 3 cases pathology of benign lesions but mammography X-ray diagnosis of malignant lesions （finally confirmed by the higher hospital pathology of malignant lesions） from March 2003 to June 2010 in our hospital to do a retrospective analysis. All patients were female, aged 33-56 years old. Results 14 cases of lobular carcinoma misdiagnosed as lobular hyperplasia, showing asymmetric dense and structural disorder in one side of lobular breast. 9 cases of ductal carcinoma in situ misdiagnosed as cystic hyperplasia of the gland, showing the limitations of structural disorder and compact but no obvious calcification in the gland;2 cases of X-ray mammography prompt lobular carcinoma in situ,misdiagnosed as hyperplastic lesions in pathology, which showed small mass surrounded by translucent edema; 1 case of papillary adenocarcinoma with the performance of light leaf mass and peripheral edema formation significantly translucent were pathology misdiagnosed as endogenous papilloma. Conclusion Misdiagnosis of breast disease happens occasionally and could caused serious harm. The benign and malignant tumors are more characteristic of a mammography X-ray findings and signs. So,do a comprehensive analysis with clinical examination and mammography X-ray signs could significantly reduce the incidence of misdiagnosis.