Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, Houston, 77030, USA.
AJR Am J Roentgenol. 2012 Apr;198(4):W386-93. doi: 10.2214/AJR.11.7341.
This purpose of this study is to describe the imaging findings in patients who presented with a diagnosis of primary breast sarcoma.
A search was performed of the pathology database at a single institution for patients with a histopathologic diagnosis of primary breast sarcoma or pure sarcomatoid carcinoma and who underwent preoperative mammography, sonography, or MRI. Patients with malignant phyllodes tumors were excluded. The imaging studies were retrospectively reviewed using the American College of Radiology BI-RADS lexicon. We documented clinical presentation, histopathologic characteristics, axillary nodal status, and the presence of distant metastases.
Twenty-four women were included in the study; their mean age was 56 years (range, 21-86 years), and the mean tumor size was 6.1 cm (range, 0.9-15 cm). Only one tumor was identified in each patient. The predominant mammographic finding was a noncalcified oval mass with indistinct (9/14 [64%]) margins. Sonography most commonly revealed an oval (19/22 [86%]) solid mass with indistinct margins (17/22 [77%]). The masses were frequently hypoechoic (18/21 [86%]) and hypervascular (17/20 [85%]) and had posterior acoustic enhancement (13/21 [62%]). MRI showed a round or oval T2-hyperintense mass with irregular margins in four of five (80%) patients, and inhomogeneous enhancement was most common (3/4 [75%]).
Primary breast sarcoma has imaging features that are not typically seen in infiltrating ductal carcinoma. A large oval hypervascular mass with indistinct margins should raise the suspicion for a primary breast sarcoma and prompt biopsy.
本研究旨在描述经病理诊断为原发性乳腺肉瘤患者的影像学表现。
在一家医疗机构的病理数据库中，对经组织病理学诊断为原发性乳腺肉瘤或纯肉瘤样癌且行术前乳腺 X 线摄影术、超声或 MRI 的患者进行了检索。排除恶性叶状肿瘤患者。使用美国放射学院 BI-RADS 词汇表对影像学研究进行回顾性分析。我们记录了临床表现、组织病理学特征、腋窝淋巴结状态以及远处转移的存在情况。
研究共纳入 24 例女性患者，平均年龄为 56 岁（范围，21-86 岁），平均肿瘤大小为 6.1cm（范围，0.9-15cm）。每位患者均仅发现 1 个肿瘤。主要的乳腺 X 线摄影表现为边界不清的非钙化卵圆形肿块（9/14 [64%]）。超声最常见的表现为边界不清的椭圆形（19/22 [86%]）实性肿块（17/22 [77%]）。肿块通常为低回声（18/21 [86%]）和高血流（17/20 [85%]），并伴有后方声增强（13/21 [62%]）。MRI 显示 4 例（80%）患者中有 5 例（80%）的 T2 高信号圆形或椭圆形肿块，边缘不规则，不均匀增强最常见（3/4 [75%]）。
原发性乳腺肉瘤的影像学特征与浸润性导管癌通常所见不同。边界不清的大卵圆形高血流肿块应提示为原发性乳腺肉瘤，并促使进行活检。
