探讨伴髓样特征非特殊型浸润性乳腺癌(invasive breast carcinoma of no special type,IBC-NST)的超声、乳腺X线摄影及磁共振成像(magnetic resonance imaging,MRI)影像学特征及相应病理组织学特征。
方法:
回顾并分析经手术后病理学检查证实的21例伴髓样特征IBC-NST患者的影像学及临床病理学特征。
结果:
21例伴髓样特征IBC-NST患者共21个病灶,15个病灶位于外上象限,20个病理组织学分级为Ⅲ级,12个分子分型为三阴性乳腺癌。超声表现示:61.9%形态不规则;57.1%边缘光整/尚光整;42.9%探及钙化灶;28.6%病灶后方回声增强;19个病灶血流较丰富,其中16个血流阻力指数较高;10个病灶行应变式超声弹性成像检查,7个示质软-中。10例患者行乳腺X线摄影检查,2例为乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)3类。6例行MRI检查,均表现为不均匀肿块型强化,5个病灶时间强度曲线(time intensity curve,TIC)为Ⅱ型。
mammography and magnehy resonance imaging (MRI) features of invasive breast carcinoma of no special type (IBC-NST) with medullary pattern
as well as the corresponding pathological features.
Methods:
Imaging and clinical pathological findings of totally 21 cases of IBC-NST with medul
lary pattern proved by postoperative pathology were analyzed retrospectively.
Results:
There were 21 lesions in 21 IBC-NST with medullary pattern patients. The 15 lesions were located in the outer upper quadrant
20 lesions were histopathologic grade Ⅲ
and 12 lesions were triple negative. Ultrasound findings showed irregular shape (61.9%)
smooth margin or moderate smooth margin (57.1%)
calcification (42.9%)
enhanced echo behind the lesions (28.6%). Nineteen lesions had abundant blood apply
and 16 of them had high resistance index. Ultrasound elastography was performed in 10 cases
and the elasticity in 7 cases was soft to medium. Mammography was performed in 10 cases
and 2 cases were classified into Breast Imaging Reporting and Data System (BI-RADS) 3. Six cases underwent MRI examination
all of which showed heterogeneous enhancement and limited diffusion. The time intensity curve (TIC) of 5 lesions was type Ⅱ.
Conclusion:
IBC-NST with medullary pattern morphologically showed benign imaging features on ultrasound and mammography. However
the blood apply in the lesion was abundant and the resistance index was high on ultrasound. MRI findings of IBC-NST with medullary pattern were basically consistent with common invasive carcinoma. The comprehensive evaluationof multiple imaging is of certain value for the diagnosis and differential diagnosis of IBC-NST with medullary pattern
and the combination of clinical features is helpful to further reduce the misdiagnosis rate.