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男性乳腺疾病:影像学-病理学表现相关性综述

Male breast disease: pictorial review with radiologic-pathologic correlation.

机构信息

Department of Radiology, Baystate Medical Center, 759 Chestnut St, Springfield, MA 01199, USA.

出版信息

Radiographics. 2013 May;33(3):763-79. doi: 10.1148/rg.333125137.

Abstract

The male breast is susceptible to many of the same pathologic processes as the female breast. Many of these conditions have mammographic, ultrasonographic (US), and magnetic resonance imaging findings that allow differentiation between clearly benign conditions and those that require biopsy. Gynecomastia is the most common abnormality of the male breast and has characteristic imaging features that usually allow differentiation from malignancy. Mammography is the initial imaging modality for a clinically suspicious mass. A palpable mass that is occult or incompletely imaged at mammography mandates targeted US. Suspicious or indeterminate masses require biopsy, which can usually be performed with US guidance. Approximately 0.7% of breast cancers occur in men. Men with breast cancer often present at a more advanced stage than do women owing to a delay in diagnosis. Benign breast neoplasms that may occur in men include angiolipoma, schwannoma, intraductal papilloma, and lipoma. Benign nonneoplastic entities that may occur in the male breast include intramammary lymph node, sebaceous cyst, diabetic mastopathy, hematoma, fat necrosis, subareolar abscess, breast augmentation, venous malformation, secondary syphilis, and nodular fasciitis. Familiarity with the salient features of the classic benign male breast conditions will allow accurate imaging interpretation and avoid unnecessary and often invasive treatment. © RSNA, 2013.

摘要

男性乳房与女性乳房一样,容易受到许多相同的病理过程的影响。许多这些病症在乳房 X 线照相术、超声(US)和磁共振成像(MRI)中具有表现,这些表现有助于区分明显良性的病症和需要活检的病症。男性乳房发育是男性乳房最常见的异常,其具有特征性的影像学特征,通常可以将其与恶性肿瘤区分开来。乳房 X 线照相术是临床可疑肿块的初始影像学检查方法。在乳房 X 线照相术中,隐匿性或不完全成像的可触及肿块需要进行靶向超声检查。可疑或不确定的肿块需要进行活检,通常可以在超声引导下进行。约 0.7%的乳腺癌发生在男性中。由于诊断延迟,男性乳腺癌患者通常比女性患者处于更晚期。男性中可能发生的良性乳腺肿瘤包括血管脂肪瘤、神经鞘瘤、导管内乳头状瘤和脂肪瘤。男性乳房中可能发生的良性非肿瘤实体包括乳腺内淋巴结、皮脂腺囊肿、糖尿病性乳腺病、血肿、脂肪坏死、乳晕下脓肿、乳房增大、静脉畸形、二期梅毒和结节性筋膜炎。熟悉典型良性男性乳腺疾病的显著特征将有助于准确进行影像学解读,避免不必要的、通常具有侵袭性的治疗。 © RSNA,2013 年。

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