Kamal M, Evans A J, Denley H, Pinder S E, Ellis I O
Department of Radiology, Nottingham City Hospital, United Kingdom.
AJR Am J Roentgenol. 1998 Nov;171(5):1331-4. doi: 10.2214/ajr.171.5.9798874.
Fibroadenomatoid hyperplasia is a well-described but rare benign breast lesion with composite features of fibroadenoma and fibrocystic change. Because fibroadenomatoid hyperplasia has not to our knowledge been reported as a cause of suspicious microcalcifications and because several pathology reports of biopsies of mammographically detected microcalcification at our institution included fibroadenomatoid hyperplasia, we undertook this study to describe the features of mammographically detected microcalcification seen in patients with fibroadenomatoid hyperplasia.
Two breast pathologists reviewed the records of 54 mammographically detected lesions that were compatible with a diagnosis of fibroadenomatoid hyperplasia and that provoked subsequent core biopsy or surgical excision of microcalcifications. Eleven cases (20%) fulfilled the diagnostic criteria for fibroadenomatoid hyperplasia. The sites of all calcifications found at histology were documented, and the mammographic features were described.
Eleven cases of fibroadenomatoid hyperplasia were identified in nine core biopsy samples and two surgical specimens. Calcification was present in all 11 pathologic specimens. Calcification was stromal in nine, subepithelial in two, and epithelial in none. The mammographic features of fibroadenomatoid hyperplasia in all 11 cases were granular microcalcifications that varied in shape, size, and density and had no associated mass; of these calcifications, 91% were in a localized, irregularly shaped cluster. Rod-shaped calcifications were also seen in 64% of cases.
Fibroadenomatoid hyperplasia is a cause of suspicious, granular, clustered microcalcifications on screening mammography. Fibroadenomatoid hyperplasia can be confirmed using 14-gauge core biopsy in most cases.
纤维腺瘤样增生是一种已被充分描述但罕见的乳腺良性病变，具有纤维腺瘤和纤维囊性变的复合特征。据我们所知，纤维腺瘤样增生尚未被报道为可疑微钙化的原因，且我们机构对乳腺钼靶检查发现的微钙化进行活检的几份病理报告中包含纤维腺瘤样增生，因此我们开展了这项研究，以描述纤维腺瘤样增生患者乳腺钼靶检查发现的微钙化特征。
两位乳腺病理学家回顾了54例乳腺钼靶检查发现的病变记录，这些病变符合纤维腺瘤样增生的诊断，且随后引发了对微钙化的粗针活检或手术切除。11例（20%）符合纤维腺瘤样增生的诊断标准。记录了组织学检查发现的所有钙化部位，并描述了乳腺钼靶特征。
在9份粗针活检样本和2份手术标本中发现了11例纤维腺瘤样增生。所有11份病理标本中均存在钙化。9例钙化位于间质，2例位于上皮下，无上皮内钙化。所有11例纤维腺瘤样增生的乳腺钼靶特征均为颗粒状微钙化，其形状、大小和密度各异，且无相关肿块；其中91%的钙化呈局限性、不规则形状的簇状分布。64%的病例中也可见杆状钙化。
纤维腺瘤样增生是乳腺钼靶筛查中可疑的、颗粒状、簇状微钙化的一个原因。在大多数情况下，使用14号粗针活检可确诊纤维腺瘤样增生。
