MRI对不同病理类型乳腺黏液腺癌的鉴别诊断

【摘要】目的：探讨MRI平扫、扩散加权成像（DWI）、动态增强及表观扩散系数（ADC）值对单纯型与混合型乳腺黏液腺癌的鉴别诊断价值。方法：回顾性分析经手术病理证实的38例单纯型乳腺黏液腺癌与16例混合型乳腺黏液腺癌患者的MRI资料,观察比较两组不同病理类型的乳腺黏液腺癌的MRI表现特征。结果：①边缘：29例单纯型黏液腺癌边缘清晰（29/40）,11例混合型黏液腺癌边缘不清晰（11/16）;②TIC曲线：24例单纯型黏液腺癌延迟期TIC曲线呈上升型（24/40）,11例混合型黏液腺癌TIC曲线呈平台型（11/16）;③ADC值：单纯型黏液腺癌平均ADC值(1.62±0.47)×10-3mm2/s高于混合型黏液腺癌平均ADC值(1.23±0.32)×10-3mm2/s。ADC值ROC曲线下面积0.733,最佳临界值1.615×10-3mm2/s,诊断敏感度和特异度分别为57.7%、88.9%。单纯型和混合型黏液腺癌在肿块边缘、TIC曲线及ADC值等方面差异均有统计学意义（P<0.05）。结论：不同病理类型的乳腺黏液腺癌MRI表现有所不同,MRI多种成像序列相结合在单纯型与混合型乳腺黏液腺癌术前诊断及鉴别诊断中具有重要价值。     

乳腺黏液腺癌MRI表现特征及其与病理对照研究

目的 探讨乳腺黏液腺癌MR平扫、动态增强(DCE)及DWI表现特征及其与病理表现的相关性.方法 MR枪查采用1.5 T MR扫描仪及乳腺专用线圈,包括MR平扫、3D DCE-MRI以及b值分别为500和1000 s/mm2的DWI.对8例行乳腺MR检查并经手术病理证实的乳腺黏液腺癌,依据乳腺影像报告和数据系统(BI-RADS)MRI标准,回顾性分析病变形态学、T1WI及T2WI信号强度、肿块内部强化特征及动态增强曲线类型、DWI上ADC值表现,并与病理对照,乳腺黏液腺癌病理诊断依据2003年WHO乳腺肿瘤病理学标准.结果 8例乳腺黏液腺癌(5例单纯黏液腺癌,3例混合型黏液腺癌)的黏液含昔为60%～90%.8例在MRI上均表现为肿块,平扫T1WI呈低信号,T2WI呈高和明显高信号.动态增强后,1例表现为不均匀轻微强化,2例表现为内部欠均匀的渐进性强化,其余5例于动态增强早期时相均表现为边缘明显强化,肿块内部结构呈渐进性强化,强化方式呈由边缘强化向中心渗透趋势.于DWI上病变均表现为明显高信号,平均ADC值在b值500 s/mm2时为(2.41±0.28)×10-3mm2/s,b值1000 s/mm2时为(2.06±0.14)×10-3mm2/s,分别高于正常乳腺组织的(1.71±0.32)×10-3和(1.43±0.24)×10-3mm2/s.结论 乳腺黏液腺癌在MR平扫T2WI、DEC及DWI表现均不同于常见的浸润性导管癌,这些特征性表现反映了其特殊的病理类型,MR多种成像序列相结合可对乳腺黏液腺癌在术前作出正确诊断.     

DWI对直肠黏液腺癌与非黏液腺癌的鉴别诊断价值

目的:探讨磁共振扩散加权成像(DWI)及其表现扩散系数(ADC)值对直肠黏液腺癌与非黏液腺癌的鉴别诊断价值.方法:回顾性分析经手术病理证实的16例直肠黏液腺癌与64例非黏液腺癌患者的MR资料,观察所有肿瘤的DWI信号强度,测量肿瘤ADC值及相对ADC(rADC)值,并绘制受试者工作特性(ROC)曲线,计算ADC值及rADC值对直肠黏液腺癌与非黏液腺癌的鉴别诊断效能.结果:16例直肠黏液腺癌中4例在DWI图像上呈低号,12例呈高信号,64例非黏液腺癌中1例呈低信号,63例呈高信号,两者DWI信号强度差异有统计学意义(x2=8.333,P=0.004).黏液腺癌的ADC值[(1.48±0.25)×10 3 mm2/s]及rADC值(1.22±0.18)均高于非黏液腺癌[(1.08±0.11)×101 mm2/s,(0.95±0.11)],差异均具有统计学意义(t=6.162,P＜0.001;t=5.810,P＜0.001).以ADC值=1.209×10 3mm2/s鉴别诊断黏液腺癌与非黏液腺癌的效能最高(AUC 0.923,敏感度93.8％,特异度89.1％).结论:DWI及ADC值在直肠黏液腺癌与非黏液腺癌的鉴别诊断中具有重要价值.     

乳腺黏液癌的MRI表现与病理对照研究

目的：分析乳腺黏液癌的 MRI 表现,并与病理对照,以提高该病的诊断水平。方法：回顾性研究经手术病理证实的16例（单纯型8例,混合型8例）乳腺黏液癌的 MRI 表现,并分析其病理基础。结果：16例乳腺黏液癌在 MRI 上均表现为肿块,平扫 T1 WI 呈等或低信号,T2 WI 呈高或明显高信号,其中7例在 T2 WI 上可见低信号分隔。16例中15例进行了动态增强,动态增强后早期轻度强化3例,延迟期2例轻度分隔样强化,1例渐进性强化;早期较明显强化12例,6例表现为早期及延迟期不均匀强化,其中1例向心性强化;6例表现为早期环状强化,其中2例延迟期仍为环状强化,4例延迟期呈向心性强化,其中1例见内部分隔样强化。TIC 早期缓慢强化3例,中度强化3例,快速强化9例,延迟期7例呈上升型,7例呈平台型,1例呈流出型。DWI 上呈高信号,在 b 值800 s/mm2时黏液癌的平均 ADC 值为（1．78±0．50）×10-3 mm2/s,单纯型黏液癌的 ADC 值（2．11±0．27）×10-3 mm2/s 高于混合型黏液癌的 ADC 值（1．49±0．48）×10-3 mm2/s,两者差异有统计学意义（P ＝0．019,P ＜0．05）。结论：乳腺黏液腺癌的病理学基础决定其 MRI 表现具有一定特征性,有助于提高诊断准确率。     

MR扩散加权成像鉴别肺良恶性病变

目的:探讨肺部良恶性病变的DWI表现及ADC值鉴别肺部良恶性病变的价值。方法:将行胸部MRI及DWI检查的肺内有直径1cm以上的结节、肿块或实性病变的64例共76个病灶作为研究对象,全部病例均经病理证实。分析病变的DWI表现,对病变进行ADC值定量分析,比较肺良恶性病变及不同组织学类型肺癌ADC值的差异。结果:恶性病变DWI上主要表现为不规则的高信号结节或肿块,良性病变主要表现为等、稍高信号的结节或肿块。恶性病变组ADC值为(1.241±0.316)×10-3 mm2/s,良性病变组ADC值为(1.819±0.409)×10-3 mm2/s,良恶性病变组ADC值的差异有高度统计学意义(P<0.001)。中央型肺癌瘤灶实质的ADC值为(1.237±0.251)×10-3 mm2/s;周围型肺癌瘤灶实质的ADC值为(1.254±0.196)×10-3 mm2/s,两者间差异无统计学意义(P>0.05)。腺癌ADC值与鳞癌、大细胞癌、小细胞癌及肉瘤样癌ADC值差异有统计学意义(P<0.05),腺癌ADC值高于其它病理类型。结论:DWI实现了肺部病变ADC值的定量分析,有望成为肺部良恶性病变鉴别诊断的一种新方法,是常规MRI检查的一个有益补充。     

乳腺黏液腺癌的钼靶X线表现与病理对照研究

目的　研究乳腺黏液腺癌的钼靶X线表现的病理基础。方法　回顾性分析 2 1例乳腺黏液腺癌的钼靶X线表现 ,与病理分型 (16例单纯型、5例混合型 )对照 ;单纯型肿瘤组尚与不同肿瘤黏液量 (少黏液量组、多黏液量组 )进行对照。结果　 (1)乳腺黏液腺癌最常见的钼靶X线表现为肿块 (15例 )和肿块伴钙化 (2例 )。少见征象如局灶性致密病变和单纯钙化各 1例 ,阴性表现 2例 ,均为单纯型多黏液量组病变。 (2 )表现为肿块的 17例黏液腺癌中 ,混合型的钼靶X线表现为浸润性边缘(5 /5 ) ;单纯型多表现为小分叶边缘及清晰边缘 (7/12 )。 (3 )表现为肿块的单纯型黏液腺癌中 ,多黏液量组多数为小分叶状边缘 (4 /7) ;而少黏液组多呈浸润性边缘 (3 /5 )。 (4 )密度改变在判断黏液腺癌的病理分型及对黏液量的判断上差异无显著意义 (P值均 >0 0 5 )。结论　不同亚型的乳腺黏液腺癌的钼靶X线表现不完全一致 ,多黏液量单纯型黏液腺癌最常见的表现为小分叶状边缘肿块 ;少黏液量单纯型和混合型黏液腺癌常有浸润性生长的影像特征     

廓清型乳腺纤维腺瘤的 MRI 诊断

目的：探讨廓清型乳腺纤维腺瘤的 MRI 表现,提高对此类型肿瘤的影像诊断水平。方法回顾性分析经病理证实的各20例MR 时间-信号曲线(TIC)呈廓清型表现的乳腺纤维腺瘤及乳腺癌的 MRI 图像,归纳、比较2组病变的形态学表现、内部信号、表观扩散系数(ADC)值以及动态增强表现,并进行统计学分析。结果动态增强扫描 TIC 为廓清型乳腺纤维腺瘤形态多为卵圆形或圆形(18/20),边界清楚(16/20),T2 WI 多呈高信号,内部可见无强化的低信号分隔(9/20);平均最小 ADC 值为(1.412±0.332)×10-3 mm2/s,高于乳腺癌(0.888±0.160)×10-3 mm2/s,差异有统计学意义(P <0.05);强化较均匀(16/20),平均早期强化率为(1.694±0.628)×100%,稍低于乳腺癌组(1.849±0.430)×100%,差异无统计学意义(P >0.05)。结论廓清型乳腺纤维腺瘤与乳腺癌在 MRI 动态增强TIC 及早期强化率方面有着相似的表现,但清楚的边缘、更高的 T2 WI 信号、内部无强化的低信号分隔以及更高的 ADC 值有助于廓清型乳腺纤维腺瘤的诊断。     

乳腺腺病瘤MRI表现特征分析

目的分析乳腺腺病瘤MRI平扫、动态增强(DCE)和扩散加权成像(DWI)表现特征,提高对腺病瘤的认识和术前诊断准确率。方法搜集2008年10月至2013年11月期间行乳腺MRI检查并经手术病理证实的8例患者9个乳腺腺病瘤,依据美国放射学会提出的乳腺影像报告和数据系统磁共振成像(BI-RADS-MRI)标准,回顾性分析病变MRI表现,包括形态学、平扫T1WI及T2WI信号、DCE表现及时间-信号强度曲线(TIC)类型、DWI信号及ADC值。结果 9个腺病瘤中8个表现为肿块,1个表现为非肿块。8个肿块型腺病瘤中,6个呈圆形或卵圆形,所有病变均边界清楚,6个边缘不规则;于平扫T1WI均呈等信号,脂肪抑制T2WI呈等或稍高信号;DCE-MRI扫描均于早期时相明显强化,早期强化率平均值为(173.2±52.8)%,4个腺病瘤内部呈不均匀强化;7个TIC呈流出型;于DWI上呈高或稍高信号,b值为500 s/mm2时,平均ADC值为(1.4±0.3)×10-3mm2/s,b值为1000 s/mm2时,平均ADC值为(1.2±0.3)×10-3mm2/s。1例非肿块型腺病瘤呈区域性分布,呈不均匀强化,TIC呈Ⅰ型。结论腺病瘤DEC-MRI扫描TIC类型和DWI上ADC值表现与乳腺癌相似,但其形态上多呈良性病变特点,MRI检查有助于乳腺腺病瘤的诊断,但确诊仍需依靠组织病理学。     

MRI在乳腺黏液癌与T2WI高信号纤维腺瘤中的诊断价值

【摘要】目的：探讨MRI对乳腺黏液癌与T2WI高信号纤维腺瘤的鉴别诊断价值。方法：回顾性分析经手术或穿刺病理证实且有完整MR影像资料的乳腺黏液癌69例和T2WI高信号纤维腺瘤76例，分别对病灶最大径、形态学、信号强度、DWI-ADC值、强化特点及TIC类型进行评价及测量。采用χ2检验对定性资料进行比较，采用独立样本t检验或秩和检验对定量资料进行比较。结果：乳腺黏液癌发病中位年龄高于纤维腺瘤（P<0.001）。纤维腺瘤较黏液癌双侧、多灶更多见（P=0.030）。形态上黏液癌以不规则形为主，纤维腺瘤以卵圆形为主（P=0.009）。黏液癌边缘不规则较纤维腺瘤多见（P=0.001）。黏液癌的平均ADC值高于纤维腺瘤，分别为（1.99±0.33）×10-3mm2/s和（1.60±0.27）×10-3mm2/s（P<0.001）。乳腺黏液癌增强早期易出现边缘强化，强化可逐渐向中心充填，延迟期呈不均匀或边缘强化；纤维腺瘤增强早期强化明显、多不均匀，延迟期强化趋于均匀一致。TIC类型黏液癌多为流入型，纤维腺瘤多为平台型（P<0.001）。结论：结合形态学、DWI-ADC值及MR强化特征，乳腺黏液癌与T2WI高信号纤维腺瘤具有较高的鉴别诊断价值。     

乳腺黏液腺癌的MRI表现与病理对照

目的 分析乳腺黏液腺癌的MRI表现,并与病理对照.方法 回顾性分析9例经手术病理证实的乳腺黏液腺癌的MRI表现,结合其病理分型(6例混合型,3例单纯型)及黏液含量进行对照研究,分析比较平扫MRI表现(形态、信号特点、边界)及其动态增强方式(强化程度、时间信号强度曲线).结果 9例乳腺黏液腺癌的MRI的表现如下.(1)形态学:分叶状6例,类圆形1例,不规则形2例.(2)信号特点:T2WI均呈高信号,T1WI低信号4例,等信号5例;内部信号均匀6例,不均匀3例.(3)边界:边界清晰7例,仅2例混合型部分边界不清.(4)动态增强方式:多呈轻中度强化,时间-信号强度曲线呈I型(持续强化型)4例,II型(平台型)3例,IV型(无或轻度强化型)2例.(5)3例单纯型细胞外黏液含量＞75%,混合型瘤体内黏液含量低于25%.瘤体内含大量的细胞外上皮性黏液,T2WI上信号强度明显增高.结论 乳腺黏液腺癌的MRI表现有一定特征,但需与浸润性导管癌、髓样癌、纤维腺瘤等进行鉴别.     

Accuracy in differentiation of mucinous and nonmucinous rectal carcinoma on MR imaging

PURPOSE: The purpose of this work was to determine the diagnostic accuracy of MRI for the differentiation of mucinous and nonmucinous carcinomas in patients with rectal carcinomas. METHOD: Seventy-six patients with pathologically proven rectal adenocarcinomas were evaluated with MRI. Both T2-weighted fast spin echo and T1-weighted spin echo images were independently reviewed by two radiologists who were blinded for tumor histology. Of the 76 cases, mucin pools were found in 28 (37%), and 16 had a mucin pool occupying >or=50% of the tumor (mucinous carcinoma). The sensitivity, specificity, accuracy, and positive and negative predictive values of distinguishing between mucinous and nonmucinous carcinomas were calculated. The interobserver agreement was estimated using kappa statistics. RESULTS: The accuracies of the diagnosis of mucinous carcinoma were 97% for Radiologist 1 and 96% for Radiologist 2. The sensitivities and specificities for diagnosing a mucinous carcinoma were 94 and 98% for Radiologist 1 and 100 and 95% for Radiologist 2, respectively. Interobserver agreement was good (kappa = 0.61) for the identification of a mucin pool and was excellent (kappa = 0.81) for the diagnosis of a mucinous carcinoma. CONCLUSION: Differentiation of mucinous and nonmucinous rectal carcinoma is highly accurate on preoperative MRI.     

Role of fine needle aspiration and tru cut biopsy in diagnosis of mucinous carcinoma of breast--from a radiologist's perspective

This study was to assess whether fine needle aspiration (FNA) or core biopsy would allow diagnosis of mucinous carcinoma of breast. In 37 mucinous carcinoma in 34 patients, 20 lesions had FNA and 24 lesions with core biopsy. FNA achieved a sensitivity of 66.7% in diagnosis of malignant lesions and 56% sensitivity in diagnosis of mucinous carcinoma. Core biopsy achieved 100% sensitivity and accuracy in the diagnosis of malignant lesions and mucinous carcinoma.     

FDG PET evaluation of mucinous neoplasms: correlation of FDG uptake with histopathologic features

OBJECTIVE: Our goal was to assess the sensitivity of positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) for the detection of mucinous carcinoma and to determine the histologic features of these tumors that may affect lesion detectability. MATERIALS AND METHODS: A retrospective review of all patients with mucinous carcinoma who had undergone FDG PET at our institution from 1995 through 1998 identified 25 patients with new or recurrent mucinous carcinoma at the time of PET. In 22 of these patients, tissue specimens available from either core biopsy or surgical resection allowed detailed histologic analysis. RESULTS: FDG PET revealed mucinous carcinoma in only 13 (59%) of 22 patients, resulting in an unusually high percentage (41%) of false-negative results. Two histologic features were found to be predictive of FDG PET results: tumor cellularity (p = 0.011) and the amount of mucin within the tumor mass (p = 0.009). There was a positive correlation between tumor FDG uptake and cellularity but a negative correlation with the amount of mucin. CONCLUSION: FDG PET is limited in the evaluation of mucinous tumors, particularly in hypocellular lesions with abundant mucin.     

Clinico-pathological characteristics of colonic carcinoma in relation to localization and histologic type

BACKGROUND/AIM: A significant increase in colonic carcinoma has been analyzed in numerous clinico-pathological studies and genetics models. The aim of this study was to determinate the differences in clinico-pathological parameters of colonic carcinoma regarding localization and histological type. METHODS: The study enrolled 124 patients who had undergone surgery for colorectal carcinoma at the Clinic of Surgery in the town of Nis within 2005. Paraffin sections were stained with Hematoxilin-eosin (H&E), High iron diamine-Alcian blue (HID-AB) (pH-2.5) and Alcian blue-Preiodic arid Shiff (AB-PAS) (pH-2.5) methods. From pathological report we used data regarding: localization (right or left colon), histological type, histological grade, and parameters which determinate the tumor stage. RESULTS: The total number of patients with right-sided colonic carcinoma was 40 (32.36%) and 84 (67.74%) with left-sided colonic carcinoma. Histopathologically, 96 (77.42%) adenocarcinomas and 28 (22.58%) mucinous adenocarcinomas were verified. There were no statistically significant differences between the right-sided and left-sided colonic carcinoma regarding sex, age, histological grade and tumor stage (p > 0.05). Mucinous adenocarcinomas was statistically significantly more frequent in right-sided colon (35.00%) than in left-sided colon (16.67%) (p < 0.05). There were no statistically significant differences between adenocarcinomas and mucinous adenocarcinomas regarding sex and disease stage. In younger patients the percentage of mucinous adenocarcinomas (28.57%) compared to non-mucinous ones (11.46%) was significantlly higher (p < 0.05) than in older patients. Mucinous adenocarcinomas had statistically significantly more frequently poor differentiation in comparision to adenocarcinomas (46.43% versus 9.37%, p < 0.001). CONCLUSION: According to the presented results it can be concluded that the lower grade of differentiation of the colon adenocarcinoma and mucinous secretion are significantly often present in younger patients.     

Fast neutron radiotherapy for advanced malignant tumors of the paranasal sinuses

The radiotherapy of advanced and low grade tumors of the internal nose and paranasal sinuses is still a problem. The results of neutron therapy of 20 patients with advanced and low grade tumors are presented. These patients were treated between July 1977 and October 1988. The mean age of patients is 53 years. Ten patients had adenoid cystic carcinomas, three patients squamous cell carcinomas, one patient a mucinous cell carcinoma, two patients a low grade adenocarcinoma and four patients low grade sarcomas. Mean follow-up is 16 months. Local control could be achieved in eleven cases. The results show that adenoid cystic carcinomas, low grade adenocarcinomas and sarcomas benefit from neutron therapy.     

MR imaging features of pure mucinous carcinoma of the breast

OBJECTIVE: To characterize MR imaging features of pure mucinous carcinoma of the breast. MATERIALS AND METHODS: MR images obtained from 16 women (age range, 29-81; mean age, 57 years) with pure mucinous carcinoma of the breast determined at surgery were reviewed. The MR findings used were shape, margin, internal mass enhancement, kinetic curve pattern on dynamic study, signal intensity on short time inversion recovery (STIR) T2-weighted images, and non-mass-like enhancement around the main tumor. Non-mass-like enhancement was compared with the presence of extensive intraductal component (EIC) on histopathological findings. RESULTS: Eleven tumors (69%) had lobular contour, and nine tumors (56%) had smooth margin. Eight tumors (50%) showed rim enhancement and six tumors (38%) showed heterogeneous enhancement. Fourteen tumors (88%) showed a persistent enhancing pattern on kinetic curve. Fifteen tumors exhibited homogenous strongly high signal intensity on STIR T2-weighted images. In six cases with EIC, five cases had non-mass-like enhancement around the main mass. CONCLUSIONS: MR findings such as lobular shape, rim or heterogeneous enhancement, persistent pattern on kinetic curve, and homogeneous strongly high signal intensity on STIR T2-weighted images may be useful in diagnosing pure mucinous carcinoma. Moreover, linear-ductal enhancement around main mass may indicate presence of EIC.     

Screen-detected mucinous breast carcinoma: potential for delayed diagnosis

AIM: To describe the imaging features of 34 screen-detected mucinous carcinomas lesions. MATERIALS AND METHODS: The BreastScreen Western Australia (WA) database between January 1991 and December 2003 was searched. During this period, 214,507 women were screened and 2745 cases of invasive carcinoma and 45 cases of mucinous carcinoma were recorded. Case notes, radiology films and pathology reports of patients with mucinous carcinoma were reviewed. Thirty-four radiologically detected pure mucinous carcinomas are described. RESULTS: Of the pure mucinous carcinomas, the average age at diagnosis was 65 years (range 48-82 years), which was higher than that of other women with breast cancer (average age 60 years) screened at BreastScreen WA. Characteristic mammographic features of mucinous carcinoma are well-circumscribed masses with lobulated margins (26/34). Only 39% (11/28) of tumours were detected at ultrasound, as the smaller lesions less than 15mm in diameter were often isoechoic with normal fat. Where histological grade was reported at excision, most (25/26) were low to medium-grade tumours (Bloom, Richardson and Elston grade I and II). A significant number of lesions (13/34) were evident on the previous screening examination where they were misinterpreted as benign lesions. However, none of these cases had positive axillary lymph nodes at final diagnosis. CONCLUSION: Although mammographically benign appearances of mucinous carcinoma caused a delay in diagnosis in 38% of the present cases, mucinous breast carcinomas have a favourable prognosis, as they are often low-grade tumours and rarely metastasize. Delay in diagnosis for these tumours in a screening programme may not lead to a significant adverse outcome for most women.     

Imaging findings in mucinous breast carcinoma and correlating factors

Objective

To investigate the factors influencing mammographic and sonographic features of mucinous breast carcinoma.

Materials and methods

Forty-six patients diagnosed as mucinous breast carcinoma between March 2005 and April 2009 were studied. Mammographies of all patients and sonographies of 41 patients were analyzed retrospectively. Microscopic slides were re-evaluated by a pathologist in order to estimate the volume of extracellular mucus which was classified as: (+), less than 50% of mucus; (++), 50–80% of mucus; and (+++), more than 80% of mucus.

Results

Thirty-one (61.3%) cases of pure mucinous type and 2 (33.3%) of mixed mucinous carcinoma presented as masses had well-defined margins on mammography. No correlation was found between margin characteristics and histological type as well as extracellular mucus rates. Denser breasts and young age group had significantly higher ratios of tumors presented with ill-defined masses than its counterpart. Sonographically, 100% lesions showed a hypoechoic lesion, 76.5% lesions in pure type and 71.4% lesions in mixed type showed a heterogeneous internal echo. No correlation was found between sonographic findings and histological type as well as extracellular mucus rates. Lesions with >40 positivity PCNA had higher ratio presented as ill-defined margins than those of ≤40% positivity PCNA.

Conclusions

The most common appearance of mucinous breast carcinoma is a mass on mammography and a hypoechoic lesion with heterogeneous internal echo on sonography. Mammographic margins and sonographic findings have no relation with histological type and extracellular mucus rate. Mammographic margin features are correlated with breast density and age and PCNA.     

Mucinous (colloid) breast cancer: mammographic and US features with histologic correlation

OBJECTIVE: Mucinous carcinoma of the breast presents with different survival rates in pure and mixed types. The purpose of this study was to correlate the mammographic and ultrasonographic findings of mucinous carcinoma with histologic features in different types and mucin rates. MATERIAL AND METHODS: Thirty-four patients (2.3%) had mucinous cancer after retrospective review of the 1439 breast cancers diagnosed between 1990 and 1996. Twenty-seven patients, 19 pure and eight mixed type of mucinous carcinomas of the breast, were included in this study to evaluate the imaging findings. In 22 of these, the microscopic slides were available and re-evaluated to estimate the volume of extracellular mucin. The volume of the extracellular mucin was classified histologically as: (+), less than 50% of mucin; (++), 50-80% of mucin; and ( ), more than 80% of mucin. Mammographic features with emphasis on margin characteristics and sonographic echo pattern of tumors were correlated with histologic findings. RESULTS: Ten cases (53%) of pure mucinous type carcinomas had a circumscribed mass lesion on the mammograms. The well-defined, lobulated margins of the masses were well correlated with pure histologic type (P<0.01; chi(2) analysis) Two-thirds of these tumors had high volume extracellular mucin. All mixed type mucinous carcinomas demonstrated poorly defined or spiculated margins with no relation to the mucin rates (P<0.01). The sonographic appearances of the tumors showed correlation with histologic types. Most of the pure type carcinomas (53%) were seen with isoechogenic echo texture relative to that of subcutaneous fat, while all of the mixed type carcinomas were hypoechogenic (P<0.01). CONCLUSION: The mammographic and sonographic features of mucinous breast carcinoma show differences in pure and mixed types of the tumor. The most common mammographic appearance of pure mucinous carcinomas with high percentages of mucin is a mass lesion having well-defined margins, which is isoechogenic relative to fat on the sonographic examination. Pure type of carcinomas with small percentages of mucin and mixed type carcinomas have more aggressive imaging characteristics.     

乳腺黏液癌的钼靶X线表现及病理分子生物学特点

目的：研究乳腺黏液癌钼靶X线表现及病理、分子生物学特点。方法：对21例乳腺黏液癌进行回顾性分析,总结其钼靶X线表现、病理基础,免疫组化检测P53、雌激素受体（ER）、孕激素受体（PR）、c-erbB-2表达状态。结果：钼靶X线表现：肿块16例,仅表现为钙化2例;结构变形3例。病理：单纯型15例,混合型6例。21例中,P53阳性8例、阴性13例;ER阳性16例、阴性5例;PR阳性18例、阴性3例。结论：乳腺黏液癌钼靶X线表现具有不同病理基础,分子生物学特点提示其预后较好。本研究为探讨其X线表现与病理学、分子生物学之间的相关性提供了参考。