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。
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.Grayscale 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 enlargement of the right axillary lymph nodes),six had posterior acoustic enhancement,and only one lesion showed posterior attenuation.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 semiquantitative blood flow classification,two lesions were grade Ⅲ,three were grade Ⅰ~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 signals,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.
作者
王惠
张勇
WANG Hui;ZHANG Yong(Department of Ultrasound,960 Hospital of PLA Joint Logistics Support Forces,Jinan 250031,China;Department of Cardiovascular Surgery,960 Hospital of PLA Joint Logistics Support Forces,Jinan 250031,China)
出处
《医学影像学杂志》
2024年第11期71-73,77,共4页
Journal of Medical Imaging
关键词
乳腺神经内分泌癌
超声检查
临床特征
误诊分析
Neuroendocrine carcinoma of the breast
Ultrasound
Clinical features
Misdiagnosis analysis
