Takano Yu, Oura Shoji, Honda Mariko
Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada, Japan.
Department of Surgery, Izumiotsu Municipal Hospital, Izumiotsu, Japan.
Case Rep Oncol. 2025 Feb 18;18(1):381-385. doi: 10.1159/000543990. eCollection 2025 Jan-Dec.
The imaging findings of elastosis, a subtype of fibrous components, have hardly been investigated in breast cancer to date.
A 70-year-old woman visited the Rinku General Medical Center for the evaluation of her left palpable breast tumor. Mammography (MMG) showed an irregular mass with segmental distribution of pleomorphic calcifications. The tumor was more clearly depicted on cranio-caudal (CC) MMG than on medio-lateral-oblique (MLO) MMG. Ultrasound showed a lobulated mass with low internal echoes, echogenic spots, and at least focally enhanced posterior echoes. Magnetic resonance imaging of the tumor showed low signal intensity on T1-weighted images and no high signal intensity on T2-weighted images and a rim enhancement pattern on subtraction images. Pathological examination of the core needle biopsy specimen showed atypical cells growing in a tubule-forming fashion. The patient underwent mastectomy and, due to the cytologically proven lymph node metastasis, axillary dissection. Postoperative pathological study showed that the tumor had large elastosis areas encompassed by malignant cells.
Diagnostic physicians should note that breast cancer-related elastosis is more clearly depicted on CC MMG than on MLO MMG, has possible enhanced posterior echoes, and shows low and no high signal intensities on T1- and T2-weighted images, respectively.
弹性组织变性作为纤维成分的一种亚型，其影像学表现迄今为止在乳腺癌中几乎未被研究过。
一名70岁女性前往临空综合医疗中心评估其左侧可触及的乳腺肿瘤。乳腺钼靶摄影（MMG）显示一个不规则肿块，伴有多形性钙化的节段性分布。该肿瘤在头尾位（CC）MMG上比在内外斜位（MLO）MMG上显示得更清晰。超声显示一个分叶状肿块，内部回声低，有回声光点，且至少局部后方回声增强。肿瘤的磁共振成像在T1加权图像上显示低信号强度，在T2加权图像上无高信号强度，在减影图像上呈边缘强化模式。粗针活检标本的病理检查显示非典型细胞呈小管形成方式生长。患者接受了乳房切除术，并且由于细胞学证实有淋巴结转移，进行了腋窝清扫术。术后病理研究表明，肿瘤有大片被恶性细胞包围的弹性组织变性区域。
诊断医生应注意，与乳腺癌相关的弹性组织变性在CC MMG上比在MLO MMG上显示得更清晰，可能有后方回声增强，并且在T1加权图像和T2加权图像上分别显示低信号强度和无高信号强度。
