Wei Yao, Zhu Qingli, Li Jianchu, Jiang Yuxin
Department of Ultrasound,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2017 Jun 20;39(3):396-400. doi: 10.3881/j.issn.1000-503X.2017.03.016.
Objective To summarize the clinical and sonographic features of mammary Paget's disease (MPD). Methods Totally 34 female patients with pathologically confirmed MPD were retrospectively recruited. According to diagnosis,the clinical data and sonographic findings were reviewed and analyzed. Results Among these 34 patients,7 patients had single MPD; in the remaining 27 patients,16 were accompanied by invasive ductal carcinoma (IDC),7 by ductal carcinoma in situ (DCIS),3 by both IDC and DCIS,and 1 by other pathologic types of carcinoma. Twenty-four patients presented with typical clinical features of MPD,whereas 10 patients had no typical features of MPD. Among the 24 patients with typical clinical features,ultrasound examinations showed that 11 had echoic abnormality in nipple-areolar complex,14 had lesions of breast,and 14 had microcalcifications. Among the 10 patients without typical clinical features,ultrasound examinations revealed echoic abnormality in nipple-areolar complex in 3 cases,breast lesions in 9 cases,and microcalcifications in 6 cases. Among the 14 patients with echoic abnormality in nipple-areolar complex,all of them presented as rich blood flow in nipple detected by color Doppler ultrasonography. Conclusions The main clinical feature of MPD is abnormalities in nipple-areolar complex. Sonography can recognize the echoic abnormalities of nipple and lesions of breast. Sonographer should be careful of the nipple-areolar complex when mass is found in breast.
目的 总结乳腺派杰氏病(MPD)的临床及超声特征。方法 回顾性纳入34例经病理确诊的MPD女性患者。根据诊断结果,对临床资料及超声表现进行回顾分析。结果 34例患者中,7例为单纯MPD;其余27例中,16例伴有浸润性导管癌(IDC),7例伴有导管原位癌(DCIS),3例同时伴有IDC和DCIS,1例伴有其他病理类型的癌。24例患者表现出MPD的典型临床特征,而10例患者无MPD的典型特征。在24例具有典型临床特征的患者中,超声检查显示11例乳头乳晕复合体回声异常,14例有乳腺病变,14例有微钙化。在10例无典型临床特征的患者中,超声检查发现3例乳头乳晕复合体回声异常,9例有乳腺病变,6例有微钙化。在14例乳头乳晕复合体回声异常的患者中,彩色多普勒超声检查均显示乳头血流丰富。结论 MPD的主要临床特征是乳头乳晕复合体异常。超声检查可识别乳头回声异常及乳腺病变。超声检查者在乳腺发现肿块时应注意乳头乳晕复合体。