CAJ | 학술논문

目的探讨乳腺神经内分泌癌的钼靶X线、超声检查表现和临床病理特征.方法回顾性分析经手术及病理证实的16例乳腺神经内分泌癌的钼靶X线、超声表现及其临床病理特征.结果 16例患者均为女性,年龄45 ～ 75岁,平均年龄67.3岁.临床表现为乳房肿块者12例,乳头溢液或溢血者4例.术后病理诊断为导管内神经内分泌癌4例,导管内神经内分泌癌伴微浸润5例,浸润性实体型神经内分泌癌7例.钼靶X线检查未见明显病变2例,可见病变14例(右乳病变6例,左乳病变8例).14例可见病变中,表现为浅分叶肿块2例;不对称或不规则致密团片影5例;圆形或类圆形肿块7例,其中皮肤增厚黏连1例,大导管扩张l例.边缘模糊7例,部分边缘模糊3例,边缘较清晰4例.16例患者无一例出现恶性钙化表现.钼靶X线检查与术后病理诊断的符合率为68.8％(11/16),超声检查与术后病理诊断的符合率为8l.3％ (13/16),钼靶X线和超声联合检查与术后病理诊断的符合率可达87.5％ (14/16).结论不伴钙化的类圆形肿块影以及不规则致密影是乳腺神经内分泌癌的常见钼靶X线表现.钼靶X线与超声联合应用有助于病变的检出和定性诊断.
목적 탐토유선신경내분비암적목파X선、초성검사표현화림상병리특정.방법 회고성분석경수술급병리증실적16례유선신경내분비암적목파X선、초성표현급기림상병리특정.결과 16례환자균위녀성,년령45 ～ 75세,평균년령67.3세.림상표현위유방종괴자12례,유두일액혹일혈자4례.술후병리진단위도관내신경내분비암4례,도관내신경내분비암반미침윤5례,침윤성실체형신경내분비암7례.목파X선검사미견명현병변2례,가견병변14례(우유병변6례,좌유병변8례).14례가견병변중,표현위천분협종괴2례;불대칭혹불규칙치밀단편영5례;원형혹류원형종괴7례,기중피부증후점련1례,대도관확장l례.변연모호7례,부분변연모호3례,변연교청석4례.16례환자무일례출현악성개화표현.목파X선검사여술후병리진단적부합솔위68.8％(11/16),초성검사여술후병리진단적부합솔위8l.3％ (13/16),목파X선화초성연합검사여술후병리진단적부합솔가체87.5％ (14/16).결론 불반개화적류원형종괴영이급불규칙치밀영시유선신경내분비암적상견목파X선표현.목파X선여초성연합응용유조우병변적검출화정성진단.
Objective The purpose of this study was to describe the X-ray features of the neuroendocrine carcinoma (NEC) of breast to raise the awareness for the disease.Methods The mammography,sonography and clinicopathologic features in a total of 16 cases of pathologically proven breast neuroendocrine carcinoma in Fudan University Cancer Hospital were analyzed retrospectively.Results All the 16 patients were women with a mean age of 67.3 years old (ranged from 45 to 75 years old).Twelve patients had palpable masses and the other four patients had outflow from the nipple.Pathological diagnosis included endocrine ductal carcinoma in situ (E-DCIS) in 4 cases,E-DCIS with microinvasion in 5,and invasive solid neuroendocrine carcinoma in 7.On mammography,9 of 16 cases exhibited round or slightly lobulated masses.Five of the 16 cases exhibited irregular or asymmetric opacities.Two of the 16 cases had negative findings.The borders of the 14 masses detected on mammography were vague in 7,partly unclear in 3 and clear-cut in 4 cases.Malignant microcalcification was not found in all cases.The accuracy rates of preoperative qualitative diagnosis for NEC with mammography and sonography were 68.8％ (11/16) and 81.3％(13/16),respectively.Given the application of combined mammography and sonography,the accuracy rates could be improved to 87.5％ (14/16).Conclusions A round mass and irregular or asymmetric opacities without malignant calcification are the most frequent appearances of mammography in neuroendocrine carcinoma of the breast.Combination of mammography and sonography may be useful to improve the accuracy of diagnosis and early detection of neuroendocrine carcinoma of the breast.