CAJ | 학술논문

目的研究乳腺恶性叶状肿瘤(MPT)临床、超声声像图表现及其病理特征,为恶性叶状肿瘤诊断提供依据.方法对手术病理证实的12例恶性叶状肿瘤患者的临床、超声声像图表现、病理形态学特征、肿瘤复发转移与临床预后进行总结分析.结果12例恶性叶状肿瘤患者超声声像图表现:肿瘤大小及部位:12例患者13个恶性叶状肿瘤位于左侧乳腺4例,右侧乳腺8例,其中8个肿瘤最大径≥5.0 cm,5个肿瘤<5.0 cm.肿瘤形态及边界:13个恶性叶状肿瘤10个呈分叶状,2个形态不规则;11个边界清晰,2个边界不清晰.内部回声及后方回声:11个内部回声不均匀,2个内部回声均匀;9个后方回声增强,6个内部伴无回声.内部钙化:1个肿瘤内出现粗大钙化,12个内部无钙化.血流分级:彩色多普勒血流成像示2个肿瘤表现为Ⅰ级血流,3个表现为Ⅱ级血流,8个表现为Ⅲ级血流.第1次手术方式:12例患者中6例采用单纯肿瘤切除活检术,2例采用肿瘤扩大切除术,4例采用乳房切除术.术后临床随访结果:术后随访20~155个月,平均(69.9±46.4)个月,其中4例肿瘤局部复发(1例复发1次,1例复发2次,1例复发3次,1例复发15次,3例第1次手术为肿瘤单纯切除术,1例第1次手术为全乳切除术),1例出现肺部转移.结论肿瘤体积较大,呈实性分叶状,内部回声不均伴无回声,血流丰富,易局部复发为乳腺恶性叶状肿瘤的临床超声表现.
목적연구유선악성협상종류(MPT)림상、초성성상도표현급기병리특정,위악성협상종류진단제공의거.방법대수술병리증실적12례악성협상종류환자적림상、초성성상도표현、병리형태학특정、종류복발전이여림상예후진행총결분석.결과12례악성협상종류환자초성성상도표현:종류대소급부위:12례환자13개악성협상종류위우좌측유선4례,우측유선8례,기중8개종류최대경≥5.0 cm,5개종류<5.0 cm.종류형태급변계:13개악성협상종류10개정분협상,2개형태불규칙;11개변계청석,2개변계불청석.내부회성급후방회성:11개내부회성불균균,2개내부회성균균;9개후방회성증강,6개내부반무회성.내부개화:1개종류내출현조대개화,12개내부무개화.혈류분급:채색다보륵혈류성상시2개종류표현위Ⅰ급혈류,3개표현위Ⅱ급혈류,8개표현위Ⅲ급혈류.제1차수술방식:12례환자중6례채용단순종류절제활검술,2례채용종류확대절제술,4례채용유방절제술.술후림상수방결과:술후수방20~155개월,평균(69.9±46.4)개월,기중4례종류국부복발(1례복발1차,1례복발2차,1례복발3차,1례복발15차,3례제1차수술위종류단순절제술,1례제1차수술위전유절제술),1례출현폐부전이.결론종류체적교대,정실성분협상,내부회성불균반무회성,혈류봉부,역국부복발위유선악성협상종류적림상초성표현.
Objective To investigate the clinical and sonographic features of malignant phyllodes tumor ( MPT) of the breast.Methods Twelve patients with pathologically diagnosed MPT who had operations in our hospital were followed up .The clinical,sonographic,pathological features and prognosis of MPT were analyzed.Results The characteristics of the 12 patients with MPT were as follows:tumor size and location:12 patients had 13 MPT.MPT located in left and right breast were in 4 and 8 patients,respectively. Eight tumors with a maximum diameter≥5.0 cm,while 5 tumors were <5.0 cm.Sonographic features:MPT manifested as lobulation in 10 tumors, irregular shape in 2 tumors;well-defined margin in 11 tumors, indistinct margin in 2 tumors;heterogeneity in 9 tumors,posterior acoustic enhancement in 9 tumors,internal anechoic area in 6 tumors,coarse calcification in 1 tumor;levelⅠblood flow in 2 tumors,levelⅡblood flow in 3 tumors,and level Ⅲblood flow in 8 tumors.Type of the first surgery:A total of 6 patients were treated by local excision,2 patients by wide excision and 4 patients by mastectomy.Follow-up results:Mean follow-up of the 12 patients were (69.9 ±46.4) months (ranged 20-155 months),with local recurrence in 4 patients(3 patients taken local excision ,1 patient taken mastectomy;1 patient relapsed for once,1 patient relapsed for twice,1 relapsed for 3 times and 1 for 15 times).One patient had lung metastases .Conclusion The clinical and sonographic features of MPT were a large ,lobulated,heterogeneous tumor with cystic area ,rich blood flow and high recurrence rate.