Cancer Center, Department of Ultrasound Medicine, Zhejiang, Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Department of Ultrasound, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Curr Med Imaging. 2023;19(6):579-586. doi: 10.2174/1573405618666220816105051.
Primary breast lymphoma (PBL) is a rare malignant breast tumor. The literature concerning PBL ultrasound is based primarily on case reports, with only a few cases reported to date.
This study aimed to elucidate the sonographic characteristics of PBL and explore the value of ultrasonography in the preoperative diagnosis of PBL using the Breast Imaging Reporting and Data System (BI-RADS).
A retrospective review of files involving a diagnosis of PBL (2013-2020) was conducted in the Department of Pathology, Zhejiang Provincial People's Hospital, Hangzhou, and the First Affiliated Hospital of Wenzhou Medical University, Wenzhou. The clinical characteristics and sonographic features of 12 lesions in 10 patients were analyzed and discussed in light of the literature.
All patients, aged 50.40 ± 14.31 years (range 30-66 years), had clinically palpable lumps. Most cases were on the right breast and were unilateral. Only one patient had mucosa-associated lymphoma. The histological type of the other patients was diffuse large B-cell lymphoma (DLBCL). Ultrasonography revealed nodular and diffuse PBL lesions without internal calcification. The nodular PBL was hypoechoic or mixed hypo- to hyperechoic, with a differential lobulated shape and horizontal growth. Although color Doppler flow imaging (CDFI) showed no significant features, the ultrasound findings were categorized as BI-RADS 4 in 10 of the 12 lesions and BI-RADS 5 in two lesions. All patients were suspected of having malignancies (BI-RADS 4 or 5).
PBL was mostly found in middle-aged and elderly women, and the right breast was more prone to the development of malignancies. PBL lesions were classified as either nodular or diffuse based on the boundaries of the tumors in the ultrasound images. Typical PBL was characterized by hypoechoic or heterogeneous lesions with circumscribed or microlobulated margins and horizontal growth. The sonographic features of the PBL lesions and the BI-RADS categorizations of the lesions analyzed suggested malignancy.
原发性乳腺淋巴瘤（PBL）是一种罕见的乳腺恶性肿瘤。有关 PBL 的超声文献主要基于病例报告，迄今为止仅报道了少数病例。
本研究旨在阐明 PBL 的超声特征，并探讨使用乳腺影像报告和数据系统（BI-RADS）对 PBL 进行术前超声诊断的价值。
回顾性分析 2013 年至 2020 年在浙江省人民医院病理科和温州医科大学附属第一医院诊断为 PBL 的患者的文件，分析并讨论了 10 例患者 12 个病灶的临床特征和超声特征，并结合文献进行了讨论。
所有患者年龄 50.40±14.31 岁（范围 30-66 岁），均有可触及的乳腺肿块。大多数病例位于右侧乳房且为单侧。仅 1 例为黏膜相关淋巴瘤，其余患者均为弥漫性大 B 细胞淋巴瘤（DLBCL）。超声显示无内部钙化的结节性和弥漫性 PBL 病变。结节性 PBL 呈低回声或混合低至高回声，形态呈差异叶状，呈水平生长。虽然彩色多普勒血流成像（CDFI）无明显特征，但 12 个病灶中的 10 个病灶的超声表现被归类为 BI-RADS 4，2 个病灶被归类为 BI-RADS 5。所有患者均怀疑为恶性肿瘤（BI-RADS 4 或 5）。
PBL 多见于中老年女性，右侧乳房更易发生恶性肿瘤。根据超声图像中肿瘤的边界，PBL 病变可分为结节性或弥漫性。典型 PBL 的特征是边界清楚或微叶状，呈水平生长的低回声或不均匀病变。PBL 病变的超声特征和病变的 BI-RADS 分类提示恶性肿瘤。
