Salvador Gabriel Lucca de Oliveira, Barbieri Poliana Palma, Maschke Laura, Nunes Anna Luisa Aranha, Louveira Maria Helena, Budel Vinicius Milani
Department of Radiology, Internal Medicine Branch, Hospital de Clinicas, Federal University of Parana, Curitiba, Brazil.
Department of Gynecology, Hospital de Clinicas, Federal University of Parana, Curitiba, Brazil.
Acta Radiol Open. 2018 Dec 6;7(12):2058460118815726. doi: 10.1177/2058460118815726. eCollection 2018 Dec.
Image-guided charcoal injection in suspicious breast lesions for preoperative localization is a procedure that has been increasing over the years because it is safer, faster, and more affordable when compared to needle-wire preoperative localization. To date, no complications have been associated with the method. However, in recent years there have been some reports about charcoal granulomas mimicking malignant lesions in some postoperative patients or in a conservative follow-up.
To report a series of 11 cases which had suspicious imaging findings for malignancy and resulted in charcoal granulomas on histopathological analysis.
A database of 1650 patients that attended our center from January 2007 to June 2018 was reviewed and detected 495 patients who had been previously submitted to ultrasound-guided charcoal marking in a breast lesion. Then, patients whose imaging studies were compatible with new suspicious lesions on mammography, breast ultrasound, and/or magnetic resonance imaging and biopsy of this new lesion indicating charcoal granuloma were selected.
From 495 patients who had undergone charcoal localization injections in previous biopsies, we selected 11 who had new lesions with malignant characteristics on imaging studies but histopathological analysis resulted in charcoal granuloma.
Charcoal granuloma should be considered in patients with previous preoperative injection localization, since the residual charcoal in the breast tissue may form granulomas and mimic malignant lesions on follow-up imaging studies.
图像引导下对可疑乳腺病变进行术前定位的木炭注射术近年来应用日益增多，因为与术前针丝定位相比，该方法更安全、更快且更经济实惠。迄今为止，尚未发现该方法有并发症。然而，近年来有一些报道称，在一些术后患者或保守随访中，木炭肉芽肿可酷似恶性病变。
报告11例具有可疑恶性影像学表现且组织病理学分析显示为木炭肉芽肿的病例。
回顾了2007年1月至2018年6月期间到本中心就诊的1650例患者的数据库，发现495例曾接受过超声引导下乳腺病变木炭标记的患者。然后，选择那些影像学检查与乳腺X线摄影、乳腺超声和/或磁共振成像上新的可疑病变相符且该新病变活检显示为木炭肉芽肿的患者。
在之前活检中接受过木炭定位注射的495例患者中，我们选择了11例在影像学检查中有恶性特征的新病变患者，但组织病理学分析结果为木炭肉芽肿。
对于之前接受过术前注射定位的患者，应考虑到木炭肉芽肿的可能，因为乳腺组织中残留的木炭可能形成肉芽肿，并在随访影像学检查中酷似恶性病变。
