摘要
目的:探讨原发性乳腺淋巴瘤(PBL)的影像学表现、临床及病理学特征。方法:回顾分析5例患者经病理证实并具有完整CT及X线影像资料,其中1例有MRI资料。结果:5例均为女性,47~69岁,平均年龄58岁。病灶分布4例位于右乳外上象限(4/5),1例位于左乳外上象限(1/5),大小局限在2~5 cm较多(4/5),1例大于5 cm (1/5),淋巴瘤多数来源于B细胞(4/5),少数来源于T细胞占(1/5)。X线上表现均为等密度肿块(5/5),部分边缘模糊(4/5),未见明显分叶及毛刺(5/5),未见钙化及腋窝肿大淋巴结(5/5),BIRADS分类3类2例(2/5),4B类2例(2/5),4C类1例(1/5)。CT表现为类圆形(1/5)、椭圆形(2/5)或不规则形(2/5)等密度影,部分边缘模糊(4/5),部分脂肪间隙紊乱(3/5)。1例患者行MRI检查,T1WI低信号,T2WI抑脂序列高信号,信号较均匀,DWI (b = 800 s/mm2)呈明显高信号,ADC值(0.73 × 10−3 mm2/s)明显减低,动态增强早期均匀强化,可见血管穿行征,延迟期持续强化,延迟晚期稍降低,可见“勾边强化征”,动态增强曲线(TIC)大致呈速升缓降型或平台型。结论:原发性乳腺淋巴瘤影像学、病理、临床均具有一定的特征,全面了解PBL的这些特征将有助于PBL的诊断,治疗及预后。
Objective: To explore the imaging, clinical, and pathological features of primary breast lymphoma. Method: A retrospective analysis was conducted on 5 patients with complete CT and X-ray imaging data confirmed by pathology, including 1 patient with MRI data. Results: All 5 cases were female, aged 47 to 69 years, with an average age of 58 years. The lesions are all distributed in the unilateral outer upper quadrant, with 4 cases located in the right outer upper quadrant and 1 case located in the left outer upper quadrant. The size is mostly limited to 2~5 cm (4/5), and 1 case is larger than 5 cm (1/5). The majority of lymphoma comes from B cells (4/5), and a few from T cells (1/5). The X-ray findings were all isodense masses (5/5), with some edges blurry (4/5), no obvious lobulation or spicules (5/5), no calcification or axillary lymph nodes (5/5), BIRADS classification 3 categories in 2 cases (2/5), 4B categories in 2 cases (2/5), and 4C categories in 1 case (1/5). CT manifestations include circular (1/5), elliptical (2/5), or irregularly shaped (2/5) isodensity shadows, some edges are blurry (4/5), and some fat spaces are disordered (3/5). One patient underwent MRI examina-tion, with low signal on T1WI and high signal on T2WI lipo suppression sequence. The signal was relatively uniform, and DWI (b = 800 s/mm2) showed significantly high signal, with an ADC value of 0.73 × 10−3 mm2/s significantly decreased, with early and uniform enhancement of dynamic en-hancement, visible vascular transit sign, continuous enhancement in the delayed phase, and slight decrease in the late delayed phase. The “hook edge enhancement sign” can be seen, and the dy-namic enhancement curve (TIC) roughly shows a rapid increase and slow decrease type or plateau type. Conclusion: Primary breast lymphoma has certain imaging, pathological, and clinical features. A comprehensive understanding of these features of PBL will help in the diagnosis, treatment, and prognosis of PBL.
出处
《临床医学进展》
2023年第10期16564-16571,共8页
Advances in Clinical Medicine
