Kim Jeongju, Ko Eun Young, Han Boo-Kyung, Ko Eun Sook, Choi Ji Soo, Kim Haejung, Kim Myoung Kyoung
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea.
Diagnostics (Basel). 2023 Aug 29;13(17):2800. doi: 10.3390/diagnostics13172800.
: To evaluate the characteristic clinical and imaging findings of charcoal granuloma and suggest features that may differentiate charcoal granuloma from breast cancer. : This retrospective study included 18 patients with a histologically confirmed breast charcoal granuloma between 2005 and 2021 at a single institution. All patients had a history of breast surgery after ultrasound (US)-guided charcoal marking. Two radiologists analyzed the radiologic findings of charcoal granulomas, including the presence of a mass or calcification; the shape, margin and density of the masses on mammography; and the location, size, shape, margin, orientation, echogenicity, vascularity, presence of an echogenic halo, and posterior acoustic shadowing on US. In cases with available follow-up images, we also investigated whether the size and shape had changed. : The median interval between breast surgery and the diagnosis of charcoal granuloma was 2.3 years (range, 0.7-18.3 years). Thirteen lesions (72.2%) were detected on screening images. In 11 (61.1%) cases, the surgical incision was not made in the tattooed skin area. Mammography showed positive findings in 10/15 patients, and most lesions were isodense masses (70%). There were no cases with calcification. On US, all lesions were masses and showed a taller-than-wide orientation (61.1%), round or oval shape (55.6%), and iso- or hyperechogenicity (83.3%). Echogenic halo (27.8%) and posterior acoustic shadowing (16.7%) were uncommon. On Doppler US, only four cases (22.2%) showed increased vascularity. Most were classified as BI-RADS 3 (38.9%) or 4A (50.0%). After biopsy, 12 patients had follow-up mammography and US. The size of the lesion decreased in nine cases and remained unchanged in three cases. A decrease in the lesion size after biopsy showed a negative correlation with the interval between detection on imaging and biopsy ( = 0.04). : Charcoal granuloma is most commonly found 2-3 years after surgery and occurs more frequently when the incision site is different from the tattooed skin area. US findings of tall and round or oval masses with iso- or hyperechogenicity without increased vascularity could help to differentiate them from malignancies.
评估炭粒肉芽肿的特征性临床和影像学表现，并提出可将炭粒肉芽肿与乳腺癌相鉴别的特征。：这项回顾性研究纳入了2005年至2021年在一家机构中18例经组织学证实的乳腺炭粒肉芽肿患者。所有患者均有超声（US）引导下炭粒标记后乳腺手术史。两名放射科医生分析了炭粒肉芽肿的影像学表现，包括肿块或钙化的存在情况；乳腺X线摄影中肿块的形状、边缘和密度；以及超声检查中肿块的位置、大小、形状、边缘、方向、回声性、血管情况、有无回声晕及后方声影。对于有可用随访图像的病例，我们还研究了大小和形状是否发生变化。：乳腺手术与炭粒肉芽肿诊断之间的中位间隔时间为2.3年（范围0.7 - 18.3年）。13个病灶（72.2%）在筛查图像上被发现。11例（61.1%）患者的手术切口不在纹身皮肤区域。乳腺X线摄影在10/15例患者中显示阳性结果，大多数病灶为等密度肿块（70%）。无钙化病例。超声检查中，所有病灶均为肿块，呈高大于宽的方向（61.1%）、圆形或椭圆形（55.6%），等回声或高回声（83.3%）。回声晕（27.8%）和后方声影（16.7%）不常见。在多普勒超声检查中，仅4例（22.2%）显示血管增多。大多数被分类为BI - RADS 3类（38.9%）或4A类（50.0%）。活检后，12例患者进行了随访乳腺X线摄影和超声检查。9例病灶大小减小，3例保持不变。活检后病灶大小减小与影像学发现至活检的间隔时间呈负相关（=0.04）。：炭粒肉芽肿最常见于术后2 - 3年，当切口部位与纹身皮肤区域不同时更易发生。超声表现为高大于宽的圆形或椭圆形肿块，等回声或高回声且无血管增多，有助于将其与恶性肿瘤相鉴别。
