Cosmacini P, Veronesi P, Zurrida S, Bartoli C, Ferranti C, Coopmans De Yoldi G
Divisione di Radiologia Diagnostica, Instituto Nazionale dei Tumori, Milano.
Radiol Med. 1991 Jul-Aug;82(1-2):52-5.
The clinical history of the phyllodes tumor and its rather complex histologic patterns, ranging from benignity to malignity, often make both preoperative diagnostic procedures and the therapeutic approach very difficult to apply strictly. We reviewed the mammographic examinations of 99 patients observed and treated at the Istituto Nazionale Tumori of Milan, 1975 to 1989, looking for a mammographic-histologic correlation useful for both an unquestionable and early diagnosis and adequate excision. Many parameters were considered for each histologic type of phyllodes tumor (65 benign, 20 borderline, and 14 malignant), such as opacity, size, shape and borders of the tumor, presence/absence of calcifications inside, and radiolucent halo. The lesion was evident in all 3 projections in 85 cases (85.5%). Tumor contour was rounded in 45 instances and polycyclic in 54. Margins were distinct or mostly distinct in 81 instances (81.8%), indistinct in 11 (11.1%), and irregular in 7 (7%). The radiolucent halo was complete in 11 cases (11.1%), incomplete in 50 (50.5%), and absent in 38 (38.4%). In our experience, the most useful and characterizing mammographic parameters were tumoral borders and opacity.
叶状肿瘤的临床病史及其相当复杂的组织学模式，从良性到恶性不等，常常使术前诊断程序和治疗方法都很难严格应用。我们回顾了1975年至1989年在米兰国家肿瘤研究所观察和治疗的99例患者的乳房X线检查，寻找有助于明确早期诊断和充分切除的乳房X线-组织学相关性。对于每种组织学类型的叶状肿瘤（65例良性、20例交界性和14例恶性），我们考虑了许多参数，如肿瘤的不透明度、大小、形状和边界、内部有无钙化以及透光环。85例（85.5%）患者的病变在所有三个投照位均清晰可见。肿瘤轮廓呈圆形的有45例，多环状的有54例。边界清晰或大多清晰的有81例（81.8%），不清晰的有11例（11.1%），不规则的有7例（7%）。透光环完整的有11例（11.1%），不完整的有50例（50.5%），无透光环的有38例（38.4%）。根据我们的经验，最有用且具有特征性的乳房X线参数是肿瘤边界和不透明度。
