Park Changsook, Jung Jung Im, Lee Ah-Won, Cheon Hae Myung, Hahn Seong Tai, Lee Jae Mun
Department of Radiology, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 62 Yeouido-dong, Youngdungpo-gu, Seoul 150-713, Korea.
J Clin Ultrasound. 2004 Jan;32(1):29-32. doi: 10.1002/jcu.10223.
In this report, we describe a case of a rare form of intraductal carcinoma of the breast known as cystic hypersecretory duct carcinoma in a 49-year-old woman with a palpable mass and no history of breast disease. Mammography showed heterogeneous dense breast tissue with no definite abnormally increased density or microcalcifications. Gray-scale sonography detected multiple small aggregated, anechoic cysts with good through-transmission in the upper outer quadrant of the left breast, corresponding to the location of the palpable mass. The patient underwent an excision biopsy, and histopathologic examination of the surgical specimen revealed multiple cysts of different size containing an eosinophilic material resembling thyroid colloid. The locations of the cysts corresponded to those of the anechoic cysts detected on sonography. The epithelium lining the cysts showed micropapillary growth consistent with a diagnosis of cystic hypersecretory duct carcinoma. The mammographic and sonographic findings in this case differed somewhat from those reported previously for this rare form of breast carcinoma. Because the imaging findings and low-power microscopic appearance of the mass in our patient's case closely resembled those of some benign breast lesions, we recommend careful differentiation of this type of lesion using high-power microscopy during histopathologic evaluation.
在本报告中，我们描述了一例罕见的乳腺导管内癌，即囊性高分泌性导管癌，患者为一名49岁女性，可触及肿块，无乳腺疾病史。乳腺钼靶检查显示乳腺组织密度不均匀且致密，无明确的异常密度增加或微钙化。灰阶超声检查在左乳外上象限发现多个小的聚集性无回声囊肿，透声良好，与可触及肿块的位置相对应。患者接受了切除活检，手术标本的组织病理学检查显示有多个大小不同的囊肿，内含类似甲状腺胶体的嗜酸性物质。囊肿的位置与超声检查发现的无回声囊肿位置一致。囊肿内衬上皮呈微乳头样生长，符合囊性高分泌性导管癌的诊断。该病例的乳腺钼靶和超声检查结果与先前报道的这种罕见类型乳腺癌的表现略有不同。由于我们患者病例中肿块的影像学表现和低倍显微镜下外观与一些良性乳腺病变非常相似，我们建议在组织病理学评估过程中使用高倍显微镜仔细鉴别此类病变类型。
