目的回顾性分析乳腺原发性淋巴瘤的超声表现及临床病理特点。方法 分析9例(共11个病灶)经病理确诊的乳腺原发性淋巴瘤患者的超声、临床及病理特征。结果 9例乳腺原发性淋巴瘤患者中,4例肿块位于右侧乳房,3例位于左侧乳房,2例位于双侧;其中8个肿块发生于外上象限。肿块大小1.5~9.0cm,平均(2.87±2.09)cm。9例均为低回声,其中5例为极低回声,4例内部回声不均匀;6例形态不规则;5例边界不清;3例后方回声增强,9例均未见钙化。彩色多普勒超声显示6例血流丰富。术后病理大体形态学均表现为实性肿物、颜色灰黄或灰粉,组织学分型7例为非霍奇金弥漫性B细胞型淋巴瘤,1例为结外黏膜相关淋巴组织淋巴瘤,1例为T细胞型淋巴瘤。结论 乳腺原发性淋巴瘤的超声检查中,低回声、外上象限、肿物后方回声增强、肿物内有丰富血流信号为主要特征,最终诊断需结合临床及术后病理,其预后与分期有关。
Objective To observe the ultrasonographic features of primary breast lymphoma and its clinical and histopathological characteristics.Methods Nine patients with primary breast lymphoma(totally 11 masses) confirmed histopathologically were retrospectively reviewed.Results Among the 9 breast lymphoma patients,4 masses located in the right breasts and 3 located in the left.Two patients had bilateral lesions.Eight masses located in the outer upper quadrant.The diameters of the masses were 1.5—9.0 cm(mean [2.87 ±2.09]cm).On ultrasound imaging,all masses were hypoecho,5 patients with extremely low echo,while 4 with asymmetry echo.The shape of mass was abnormal in 6 patients,indistinct margins were found in 5 patients,heterogeneous internal echo was detected in 4 patients,while posterior enhancement was noticed in 3 patients.Calcification was not found in all masses.On color Doppler flow imaging,abundant vascularity was detected in 6 patients.On gross histopathological examination,the tumors were pale yellow or pale pink colored,firm with mostly smooth margins.The masses in 7patients were non-Hodgkin lymphoma diffuse B cell type,1 was mucosa-associated lymphoid tissue lymphoma and 1 was T cell type.Conclusion Primary breast lymphoma has some ultrasonic characteristics,including hypoecho,outer quadrant location,posterior enhancement and abundant vascularity.Final diagnosis depends on the histopathology.Prognosis of primary breast lymphoma is related with its stage.