1 Department of Radiology, Research Institute of Radiology, Chung-Ang University Hospital, Seoul, Korea.
2 Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 gil, Songpa-gu, Seoul 05505, Korea.
AJR Am J Roentgenol. 2018 Jun;210(6):1386-1394. doi: 10.2214/AJR.17.18515. Epub 2018 Apr 27.
The purpose of this article is to investigate the radiologic and clinicopathologic findings of mucocelelike lesions (MLLs) and the rate of pathologic upgrade with factors predicting it.
We reviewed our institution's database from January 2006 to December 2012 and enrolled 89 women with 89 MLLs. The pathologic findings from the initial biopsies identified 71 lesions without and 18 lesions with associated high-risk lesions. Images were reviewed according to the BI-RADS lexicon. Clinical and pathologic results were analyzed statistically, and upgrade rates were calculated.
Of the 89 lesions, 67 (75.3%) underwent surgical excision and 22 (24.7%) did not. After surgical excision (n = 67), one lesion was upgraded to mucinous carcinoma, three were upgraded to ductal carcinoma in situ, and 16 were upgraded to MLLs with associated high-risk lesions (29.9% total upgrade rate; 20/67). A statistically significant higher percentage of MLLs with associated high-risk lesions was observed in the surgical excision group (94.4% vs 70.4%; p = 0.036). The final pathologic diagnosis revealed larger lesions (16.4 ± 9.1 vs 12.6 ± 6.8 mm; p = 0.024) and younger patients in the high-risk group (46.9 ± 7.7 vs 50.6 ± 9.1 years; p = 0.049). Although no significant differences were observed in the imaging findings, including the BI-RADS category, upgraded lesions were seen as a mass with calcification as a predominant feature.
This study revealed no significant differences in imaging findings or BI-RADS category between high-risk and non-high-risk breast MLLs. However, we confirmed that high-risk lesions typically are seen as larger masses with calcifications.
本文旨在探讨黏液样病变（MLL）的影像学和临床病理表现，以及与病理升级相关的预测因素。
我们回顾了 2006 年 1 月至 2012 年 12 月期间我院的数据库，并纳入了 89 名患有 89 个 MLL 的女性患者。初始活检的病理结果确定了 71 个无高危病变的病变和 18 个伴有高危病变的病变。我们根据 BI-RADS 词汇表对图像进行了回顾。对临床和病理结果进行了统计学分析，并计算了升级率。
89 个病变中，67 个（75.3%）接受了手术切除，22 个（24.7%）未接受手术切除。在接受手术切除的 67 个病变中，有 1 个病变升级为黏液性癌，3 个升级为导管原位癌，16 个升级为伴有高危病变的 MLL（总升级率为 29.9%；20/67）。在手术切除组中，伴有高危病变的 MLL 比例明显更高（94.4% vs 70.4%；p = 0.036）。最终的病理诊断显示，高危组的病变更大（16.4 ± 9.1 vs 12.6 ± 6.8 mm；p = 0.024），患者更年轻（46.9 ± 7.7 vs 50.6 ± 9.1 岁；p = 0.049）。尽管在影像学表现，包括 BI-RADS 类别方面，未观察到显著差异，但我们证实高危病变通常表现为较大的伴有钙化的肿块。
本研究表明，高危和非高危乳腺 MLL 之间的影像学表现或 BI-RADS 类别无显著差异。然而，我们证实高危病变通常表现为较大的伴有钙化的肿块。
