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中华医学超声杂志(电子版) ›› 2015, Vol. 12 ›› Issue (05) : 408 -412. doi: 10.3877/cma.j.issn.1672-6448.2015.05.015

所属专题: 乳腺超声 文献

浅表器官超声影像学

乳腺原发性鳞状细胞癌的临床、病理及超声特征
杨倩1, 朱庆莉1,(), 姜玉新1, 李建初1, 王红燕1, 张璟1, 刘赫1, 李娜1, 游珊珊1, 孝梦甦1, 王铭1   
  1. 1. 100730 中国医学科学院 北京协和医学院 北京协和医院超声诊断科
  • 收稿日期:2015-01-29 出版日期:2015-05-01
  • 通信作者: 朱庆莉
  • 基金资助:
    国家自然科学基金项目(81371557)

Clinical, histopathological and ultrasonographic features of primary squamous cell carcinoma of the breast

Qian Yang1, Qingli Zhu1,(), Yuxin Jang1, Jianchu Li1, Hongyan Wang1, Jing Zhang1, He Liu1, Na LI1, Shanshan You1, Mengsu Xiao1, Ming Wang1   

  1. 1. Department of Diagnostic Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
  • Received:2015-01-29 Published:2015-05-01
  • Corresponding author: Qingli Zhu
  • About author:
    Corresponding author: Zhu Qingli, Email:
引用本文:

杨倩, 朱庆莉, 姜玉新, 李建初, 王红燕, 张璟, 刘赫, 李娜, 游珊珊, 孝梦甦, 王铭. 乳腺原发性鳞状细胞癌的临床、病理及超声特征[J]. 中华医学超声杂志(电子版), 2015, 12(05): 408-412.

Qian Yang, Qingli Zhu, Yuxin Jang, Jianchu Li, Hongyan Wang, Jing Zhang, He Liu, Na LI, Shanshan You, Mengsu Xiao, Ming Wang. Clinical, histopathological and ultrasonographic features of primary squamous cell carcinoma of the breast[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(05): 408-412.

目的

总结乳腺原发性鳞状细胞癌临床超声及病理特征。

方法

对7例1995年1月至2014年12月北京协和医院临床收治并经超声及手术病理检查证实为乳腺原发性鳞状细胞癌患者的临床、病理及超声声像图特征进行总结分析。

结果

7例乳腺原发性鳞状细胞癌患者8个乳腺原发灶中单发6例,多发1例;大小7.0~60.0 mm,平均大小(34.0±19.6)mm;其中6个呈实性低回声,2个呈囊实性混合回声;8个原发灶形态均不规则、边界模糊;2个出现点状及条状钙化。彩色多普勒血流成像示7个原发灶血流丰富(Ⅱ或Ⅲ级),1个原发灶未见血流(0级)。术后病理大体标本示8个乳腺肿物中实性6个,颜色灰白,质中,边界不清;2个肿物内部分呈囊腔样。1例70岁老年患者乳腺癌根治术后胸壁多次复发,超声显示胸壁复发灶呈厚壁无回声;2个胸壁复发灶大体标本示肿物均呈囊腔,囊壁厚,镜检示纤维脂肪及骨胳肌组织内见鳞状细胞癌浸润。

结论

乳腺原发性鳞状细胞癌病灶较大,超声显示肿瘤内部较多囊性成分和丰富血流,对诊断乳腺原发性鳞状细胞癌有帮助。

Objective

To observe the ultrasonographic features of primary squamous cell carcinoma of the breast and its clinical and histopathological characteristics.

Methods

The ultrasonographic features, clinical and histopathological characteristics of 7 middle-aged women (median age 61 years old) with primary squamous cell carcinoma of the breast confirmed histopathologically from January 1995 to December 2014 in Peking Union Medical College Hospital were retrospectively reviewed.

Results

There were 8 lesions in seven cases. Six cases were single lesion and 1 case with multiple lesions, the diameters of the lesions were 7.0-60.0 mm [mean (34.0±19.6) mm]. On grayscale ultrasound, 6 lesions with solid compoments were hypoechoic, 2 lesions with solid and cystic compoments were complex echogenic, the lesions all had irregular shape and indistinct margin, 2 lesions had calcifications. On color Doppler flow imaging, 7 lesions had rich blood flow signals (Ⅱ or Ⅲ) and 1 lesion had no blood flow signal. On gross histopathological examination, 6 masses were solid, pale-white colored, medium texture and the boundary was not clear. Two masses had cystic cavity. One old patient who was 70 years old had several times chest wall recurrence after mastectomy. On ultrasonography, the lesion showed an anechoic cyst with thick wall. Two chest wall recurrence lesions were cystic with thick wall. Microscopic examination showed squamous cell carcinoma infiltrating into the fiber adipose and skeletal muscle tissue.

Conclusions

Primary squamous cell carcinoma of the breast is more common in large tumor size. Ultrasound can show the more cystic components of the tumor and abundant vascularity, which is helpful for diagnosis.

图1~6 乳腺原发性鳞状细胞癌术前超声声像图及病理图。图1~3患者女性,68岁,因触及左乳肿物2个月余就诊,术前二维超声声像图示左乳外上象限囊实性病灶,大小57.0 mm×48.0 mm,呈混合回声,低回声伴大片状无回声,形状不规则,边界不清;彩色多普勒血流成像示病灶内部丰富不规则血流,术后病理诊断:乳腺原发性鳞状细胞癌(化生性癌,HE ×100);图4~6患者女性,70岁,左乳腺原发性鳞状细胞癌改良根治术后3个月,左侧胸壁二维纵切面超声声像图示左侧胸壁皮下见无回声,囊壁较厚,大小31.7 mm×26.7 mm病灶,内可见点状中低回声沉积;伴后方回声增强,术后病理诊断:胸壁纤维脂肪骨骼肌内见鳞状细胞癌浸润,考虑为乳腺癌胸壁复发(HE ×100)
表1 7例乳腺原发性鳞状细胞癌患者临床检查、超声表现及病理诊断结果
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