中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
7期
3-5
,共3页
乳腺%导管内乳头状瘤病
乳腺%導管內乳頭狀瘤病
유선%도관내유두상류병
Breast%Intraductal papillamatosis
目的 探讨乳腺导管内乳头状瘤病的临床、影像学特点及其与病理变化的关系.方法 回顾性分析我院近4年来诊治的57例导管内乳头状瘤病患者的临床资料,复习其临床表现、影像学及组织学特点.结果 57例患者平均年龄40.46岁,其中29～40岁占57.89%,乡镇居民36例(63.16%).病理合并非典型增生27例(45.76%).57例临床表现为乳头溢液或(和)乳痛伴或不伴乳腺包块半月～5年余.钼靶摄影提示为乳腺增生,造影可提示导管内乳头状瘤.彩超可见弱回声或实性回声结节,界清～蟹足状不清,CDFI结节内无～线状～明显有血流信号不等.合并癌变者钼靶示成簇点状钙化,导管扩张、僵硬,邻近导管斑片状造影剂散布;彩超见弱回声团,界限欠清,回声均质无钙化或不均质有点状强回声钙化且血流丰富.18例患者行包块单纯切除,切除边界距病变外约0.5 cm.其余全部行术中冷冻病检,细胞生长活跃或不典型者,将瘤体所在腺叶楔形切除;恶变者行改良根治术.其中有4例患者于术后0.5～1.6年复发,后行乳段切除术.结论 导管内乳头状瘤病多合并乳头溢液,钼靶造影诊断较敏感,但确诊需病检.治疗以手术切除为主,多伴非典型增生,术后需加强回访.
目的 探討乳腺導管內乳頭狀瘤病的臨床、影像學特點及其與病理變化的關繫.方法 迴顧性分析我院近4年來診治的57例導管內乳頭狀瘤病患者的臨床資料,複習其臨床錶現、影像學及組織學特點.結果 57例患者平均年齡40.46歲,其中29～40歲佔57.89%,鄉鎮居民36例(63.16%).病理閤併非典型增生27例(45.76%).57例臨床錶現為乳頭溢液或(和)乳痛伴或不伴乳腺包塊半月～5年餘.鉬靶攝影提示為乳腺增生,造影可提示導管內乳頭狀瘤.綵超可見弱迴聲或實性迴聲結節,界清～蟹足狀不清,CDFI結節內無～線狀～明顯有血流信號不等.閤併癌變者鉬靶示成簇點狀鈣化,導管擴張、僵硬,鄰近導管斑片狀造影劑散佈;綵超見弱迴聲糰,界限欠清,迴聲均質無鈣化或不均質有點狀彊迴聲鈣化且血流豐富.18例患者行包塊單純切除,切除邊界距病變外約0.5 cm.其餘全部行術中冷凍病檢,細胞生長活躍或不典型者,將瘤體所在腺葉楔形切除;噁變者行改良根治術.其中有4例患者于術後0.5～1.6年複髮,後行乳段切除術.結論 導管內乳頭狀瘤病多閤併乳頭溢液,鉬靶造影診斷較敏感,但確診需病檢.治療以手術切除為主,多伴非典型增生,術後需加彊迴訪.
목적 탐토유선도관내유두상류병적림상、영상학특점급기여병리변화적관계.방법 회고성분석아원근4년래진치적57례도관내유두상류병환자적림상자료,복습기림상표현、영상학급조직학특점.결과 57례환자평균년령40.46세,기중29～40세점57.89%,향진거민36례(63.16%).병리합병비전형증생27례(45.76%).57례림상표현위유두일액혹(화)유통반혹불반유선포괴반월～5년여.목파섭영제시위유선증생,조영가제시도관내유두상류.채초가견약회성혹실성회성결절,계청～해족상불청,CDFI결절내무～선상～명현유혈류신호불등.합병암변자목파시성족점상개화,도관확장、강경,린근도관반편상조영제산포;채초견약회성단,계한흠청,회성균질무개화혹불균질유점상강회성개화차혈류봉부.18례환자행포괴단순절제,절제변계거병변외약0.5 cm.기여전부행술중냉동병검,세포생장활약혹불전형자,장류체소재선협설형절제;악변자행개량근치술.기중유4례환자우술후0.5～1.6년복발,후행유단절제술.결론 도관내유두상류병다합병유두일액,목파조영진단교민감,단학진수병검.치료이수술절제위주,다반비전형증생,술후수가강회방.
Objective To explore the clinical and image features of breast intraductal papillomatosis and their relationship with pathological change. Methods The clinical manifestitions, images and histologic features of 57 cases of intraductal papillomatosis were retrospectively analysed. Results The mean age of patients was 40.46 years old,and the rate was 57.89% between the 29 to 40 years old, the occupation of small towns' residents were 36 cases(63.16%).There were 27 patients(45.76%) had intraductal papillomatosis associated with atypical hyperplasia. Nipple discharge or/and mastalgia associated with or without mass persisted half-month to 5 years more long time were the clinical manifestition. Hyperplasia of mammography and intraductal papillomatosis of galactography were indicated. Solid echopattern or weak echonodus were seen on color ultrasound, and bloodstream signals were different from no to line and significance in the node. Clustering punctate calcifications and patching contrast agent dispersal in circaduct and the ductal ectasia or rigidity were showed up on the mammography when combined carcinoma. Weak echo clump and unclear boundary with or without punctiform calcification and abundance bloodstream were seen on the color ultrasound. The masses of 18 patients were simple resected around 0.5 cm from the boundary. The gland lobe wedge resection were practiced which freezing slide showing cell growth active or atypical and improved radical correction were done to those who were malignant. There were four patients recur after postoperation from half year to one year and seven months and galactosegment ectomy were performed. Conclusions Most intraductal papillomatosis complicated with nipple discharge and fairly sensitivity to mammography but final diagnosis required biopsy. Exairesis was the principal therapeutica way and followed up need emphasized for most lesions complicated with atypical hyperplasia.
