基础医学与临床 ›› 2015, Vol. 35 ›› Issue (5): 621-625.

• 研究论文 • 上一篇    下一篇

乳腺癌改良根治术后胸壁新发良性肿物的超声特征

杨倩1,朱庆莉1,姜玉新1,李建初2,张璟1,王红燕1,游珊珊1   

  1. 1. 北京协和医院
    2. 中国医学科学院 北京协和医学院 北京协和医院
  • 收稿日期:2015-01-23 修回日期:2015-03-13 出版日期:2015-05-05 发布日期:2015-04-28
  • 通讯作者: 姜玉新 E-mail:jiangyuxinxh@163.com
  • 基金资助:
    国家自然科学基金项目

Ultrasonographic features of chest wall newly developed benign mass after mastectomy for breast cancer

  • Received:2015-01-23 Revised:2015-03-13 Online:2015-05-05 Published:2015-04-28

摘要: 目的 探讨乳腺癌改良根治术后胸壁新发良性肿物的超声表现特点。方法 回顾性分析19例乳腺癌改良根治术后胸壁新发肿物并被病理证实为良性患者的超声表现及临床病理特征。结果 19例患者乳腺癌改良根治术后3个月~10年胸壁新发良性肿物,其中73.7%(14/19)集中于术后2年内,24个病灶大小4.0~45.0 mm,术后病理诊断证实: 45.8%(11/24)为脂肪坏死,33.3%(8/24)为炎性反应伴异物巨细胞反应,其他20.9%(5/24)。24个胸壁病灶术前超声正确提示11个(11/24,45.8%)为良性病变可能,其中脂肪坏死4个,超声表现:2个低或无回声,形态规则,边界清,未见血流;2个低回声,形态不规则,边界不清,内可见中高回声或钙化,未见血流。炎性反应伴异物巨细胞反应5个均为多发病灶,超声表现:3个伴显著后方回声衰减,2个呈中高回声,少或未见血流。1个脂肪瘤及1个纤维脂肪组织急性及慢性炎症均表现为中高回声。结论 乳腺癌根治术后患者胸壁新发良性肿物的时间多在手术后2年内,病理类型复杂,多见脂肪坏死或炎症伴异物巨细胞反应,超声表现多样,需依靠病理明确诊断。

关键词: 【关键词】超声, 乳腺癌, 胸壁良性肿物

Abstract: Objective To observe the ultrasonographic features of chest wall newly developed benign mass after mastectomy for breast cancer Methods The ultrasonographic features, clinical and histopathological characteristics of 19 patients with chest wall newly developed benign mass after mastectomy confirmed histopathologically were retrospectively reviewed. Results The postoperative time of 19 patients with chest wall newly developed benign nodule after mastectomy ranged from 3 months to 10 years and 73.7% (14/19) occured within 2 years after mastectomy. The size of the 24 lesions ranged from 5.4 mm to 114.7mm. Confirmed by postoperative pathologic diagnosis: 45.8% (11/24) for fat necrosis, 33.3% (8/24) for inflammation and foreign body giant cell reaction, the other 20.9% (5/24). Preoperative ultrasonography correctly suggested that 11 (11/24, 45.8%) chest wall lesions would be benign lesions, including 4 fat necrosis, 5 inflammation and foreign body giant cell reaction, 1 lipoma and 1 fibrous and fat tissue of inflammation. On ultrasonography, 2 lesions of fat necrosis showed hypoechoic or anechoic, regular shape, clear boundary and no blood flow signal, 2 lesions of fat necrosis showed hypoechoic, irregular shape, indistinct margin, visible in hyperechoic or calcification, no blood flow signal. Five lesions for Inflammation and foreign body giant cell reaction showed that 3 lesions had significant posterior echo attenuation, 2 lesions were hyperechoic, 5 lesions had little or no blood flow signal. One lesion for lipoma and 1 lesion for fibrous and fat tissue of inflammation showed hyperechoic. Conclusions The chest wall newly developed benign mass often occured within 2 years after mastectomy. The pathological type is complex, but often for fat necrosis and inflammation and foreign body giant cell reaction. The sonographic features are varied and the diagnosis still depends on histopathology.

Key words: 【Key words】 Ultrasonography, Breast neoplasms, chest wall benign mass