20例乳腺弥漫大B 细胞淋巴瘤超声误诊分析
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南京医科大学第一附属医院超声医学科,南京医科大学第一附属医院超声医学科

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Analysis of 20 cases of misdiagnosis of breast diffuse large B cell lymphoma
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the First Affiliated Hospital of Nanjing Medical University,

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    摘要:

    摘 要 目的 探讨乳腺弥漫大B细胞淋巴瘤(DLBCL)的超声误诊原因。方法 回顾性分析20例经病理确诊的乳腺DLBCL患者的临床及超声影像学检查资料,分析超声误诊原因。结果 20 例患者根据常规超声图像有无边界分为肿块型12例和弥漫型8例。9例行应变弹性成像检查,弹性评分2分5例,3分4例;1例行超声造影和SWE检查,超声造影呈不均匀高增强,SWE呈Ⅰ型。超声诊断BI-RADS 4类19例,其中4A类4例、4B类8例及4C类7例;BI-RADS 3类1例。常规超声结合弹性成像、超声造影正确诊断为乳腺淋巴瘤者5例,误诊15例,包括误诊为乳腺癌10例,炎症病变4例,错构瘤1例。结论 DLBCL常规超声检查极易误诊,充分认识其常规超声表现并联合超声造影及弹性成像技术可提高其诊断准确率。

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    ABSTRACT Objective To analysis the reasons of ultrasonic misdiagnosis of breast diffuse large B cell lymphoma(large B-cell lymphoma diffuse,DLBCL). Methods The clinical and ultrasonic data of 20 patients with breast DLBCL diagnosed by pathology in our hospital were retrospectively analyzed,and the causes of ultrasonographic misdiagnosis were analyzed. Results The ultrasonic appearances of 20 cases of breast DLBCL were divided into mass type(12 cases) and diffuse type(8 cases). 9 cases of elastography showed soft or medium stiff lesions,and 1 case of contrast-enhanced ultrasound showed inhomogeneous enhancement. According to BI-RADS-US classification,19 cases were diagnosed as BI-RADS 4,including 4 cases of 4A,8 cases of 4B and 7 cases of 4C,1 case was diagnosed as BI-RADS 3. 5 cases were preoperative diagnosis of breast lymphomay by conventional ultrasound combined with contrast-enhanced ultrasound and elastography.10 cases were misdiagnosed as breast cancer. 4 cases were misdiagnosed as inflammatory lesions.Only 1 case was misdiagnosed as BI-RADS 3 and was concerned as breast hamartoma.Conclusion Breast DLBCL is easily misdiagnosed by ultrasound. It can improve the diagnostic accuracy by fully understanding the conventional ultrasound findings and combined with contrast-enhanced ultrasound and elastography.

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邓晶[],李奥[].20例乳腺弥漫大B 细胞淋巴瘤超声误诊分析[J].临床超声医学杂志,2017,19(5):

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  • 收稿日期:2016-12-03
  • 最后修改日期:2017-04-08
  • 录用日期:2017-01-24
  • 在线发布日期: 2017-06-28
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