乳腺神经内分泌癌的超声表现及其临床特征分析
Ultrasonic manifestations and analysis of the clinical features of neuroendocrine carcinoma of the breast
王惠 1张勇2
作者信息
- 1. 中国人民解放军联勤保障部队第九六〇医院超声诊断科 山东 济南 250031
- 2. 中国人民解放军联勤保障部队第九六〇医院外科 山东 济南 250031
- 折叠
摘要
目的 探讨乳腺神经内分泌癌(NEBC)的超声表现及其临床特征,并分析部分患者误诊原因.方法 选取我院经病理确诊为NEBC的 7 例患者共 8 个病灶(1 例患者双侧乳腺各 1 个NEBC病灶)为观察对象,采用灰阶超声检查及彩色多普勒超声检查.结果 7 例患者 8 个病灶,4 例病灶呈现典型恶性肿瘤表现,3 例病灶呈现良性表现(其中 1 例结合腋窝淋巴结异常肿大,怀疑为恶性),1 例表现为导管局限性扩张诊断为导管内乳头状瘤,诊断符合率为 50.0%(4/8),漏诊率为 12.5%(1/8).2 例患者出现乳头溢液(其中 1 例超声检查未发现病灶,另 1 例首诊未发现病灶,半年后行乳管镜发现导管内新生物,此时超声检查发现结节).超声检查所见 7 个病灶均为低回声,5 个回声不均匀,4 个边界清晰,6个形态不规则,1 个形态规则(此患者右侧腋窝淋巴结异常肿大),6 个后方回声增强,1 个病灶后方衰减.2 个病灶内显示微钙化,2 例同侧腋窝淋巴结转移.Adler血流半定量法:2 个病灶Ⅲ级,3 个Ⅰ～Ⅱ级,3 个 0 级.结论 NEBC呈现不均匀低回声,形态不规则,病灶后方增强或无明显衰减,病灶内较少出现微钙化,体积较大病灶多数表现为血流信号丰富或较丰富,体积较小病灶不易检出血流信号,二维灰阶及彩色多普勒超声检查有助于NEBC的定性诊断.
Abstract
Objective To investigate the ultrasonic manifestations and clinical features of neuroendocrine carcinoma of the breast(NEBC)and to analyze the reasons for misdiagnosis in some cases.Methods Seven patients with a total of eight lesions(one patient had one lesion in each breast,both confirmed as NEBC)confirmed by pathology were selected in this work.Gray-scale ultrasound and color Doppler ultrasound examinations were used for the diagnosis.Results Among the seven patients with eight lesions,four lesions showed typical malignant tumor features,three lesions showed benign features(one of which was suspected to be malignant due to abnormal enlargement of the axillary lymph nodes),one lesion manifested as localized ductal dilatation and was diagnosed as intraductal papilloma.The diagnostic accuracy rate was 50.0%(4/8),and the missed diagnostic rate was 12.5%(1/8).Two patients presented with nipple discharge(one had no lesions detected on ultrasound,while the other had no lesions detected at the initial diagnosis but a ductal neoplasm was found on ductoscopy six months later,and a nodule was then detected by ultrasound).Ultrasonic findings were as follows:all seven lesions were hypoechoic,five had heterogeneous echogenicity,four had clear boundaries,six had irregular shapes,one had a regular shape(but the patient had abnormal en-largement of the right axillary lymph nodes),six had posterior acoustic enhancement,and only one lesion showed posterior at-tenuation.Microcalcifications were visible in two lesions.Lymph node metastasis in the ipsilateral axilla was observed in two cases.No abnormal enlargement of lymph nodes was seen in the supraclavicular or infraclavicular fossa.According to Adler's semi-quantitative blood flow classification,two lesions were grade Ⅲ,three were gradeⅠ～Ⅱ,and three were grade 0.Conclusion NEBC lesions are characterized by heterogeneous hypoechoic appearance,irregular shapes,posterior acoustic enhancement or no significant attenuation,infrequent microcalcifications.arger lesions often show abundant or relatively abundant blood flow sig-nals,while smaller lesions are less likely to show blood flow signals.Two-dimensional gray-scale and color Doppler ultrasound are helpful for the qualitative diagnosis of NEBC.
关键词
乳腺神经内分泌癌/超声检查/临床特征/误诊分析Key words
Neuroendocrine carcinoma of the breast/Ultrasound/Clinical features/Misdiagnosis analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据