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[累及乳腺的继发性非霍奇金B细胞淋巴瘤:影像学表现]

[Secondary non-Hodgkin's B-cell lymphoma involving the breast: radiologic imaging].

作者信息

Roldán-Valadez Ernesto, García-Blanco María del Carmen, Rojas-Marín Carlos, Sánchez-Avila Francisco, León-Rodrìguez Eucario, Hernández-Ortiz Jorge

机构信息

Departamento de Radiología e Imagen, Fundación Clínica Médica Sur, México DF.

出版信息

Gac Med Mex. 2005 Jan-Feb;141(1):63-7.

Abstract

Secondary lymphomas involving the breast, although uncommon, represent the largest group of metastasic tumors to the breast. Primary non-Hodgkin lymphomas (NHLs) of the breast are also rare, accounting for 1.7% to 2.2% of extranodal NHL cases and 0.38 to 0.7% of all NHLs. Approximately 300 cases have been reported in the Medical literature. Mammographic appearances are described as round or oval areas of opacity. The breast mass may appear homogeneous or inhomogeneous. The lesion may be very well defined and may be mistaken for a benign process, most notable in patients younger than 35 years of age. Ultrasonographic appearance is described as a sharply defined mass with low or medium echoes. The posterior aspect of the mass is well defined (possibly with slight acoustic enhancement but with no associated posterior shadowing). In summary, the mammographic appearance of the breast lymphoma is nonspecific, but the diagnosis can possibly be excluded if calcifications or a desmoplastic reaction are present. Prominent lymph vessels in a patient with a breast mass should raise the suspicion of breast lymphoma. The most critical aspect in the workup of a breast mass is the tissue biopsy, since radiographically lymphomatous lesions are indeterminate. We present the case of a 79-year-old woman with abdominal pain and a palpable breast mass; we also make a brief summary of the clinical features and main imaging findings of NHL (plain radiograph, mammography, breast ultrasound and thorax tomography).

摘要

继发性淋巴瘤累及乳腺虽不常见,但却是乳腺转移瘤中最大的一组。乳腺原发性非霍奇金淋巴瘤(NHL)也很罕见,占结外NHL病例的1.7%至2.2%,占所有NHL的0.38%至0.7%。医学文献中已报道约300例。乳腺钼靶表现为圆形或椭圆形密度增高区。乳腺肿块可呈均匀或不均匀密度。病变边界可能非常清晰,可能被误诊为良性病变,在35岁以下患者中最为明显。超声表现为边界清晰的肿块,回声低或中等。肿块后方边界清晰(可能有轻微声增强但无相关后方声影)。总之,乳腺淋巴瘤的钼靶表现不具特异性,但如果存在钙化或促纤维组织增生反应,则可能排除诊断。乳腺肿块患者出现明显的淋巴管应怀疑乳腺淋巴瘤。乳腺肿块检查中最关键的方面是组织活检,因为淋巴瘤病变在影像学上难以确定。我们报告一例79岁腹痛且可触及乳腺肿块的女性病例;我们还简要总结了NHL的临床特征和主要影像学表现(平片、乳腺钼靶、乳腺超声和胸部断层扫描)。

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