男性乳腺发育症和男性乳腺癌的X线和超声影像分析
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摘要
目的:探讨男性乳腺发育症和男性乳腺癌的X线、超声征象。方法:收集2007年3月—2017年12月经手术或穿刺病理证实的13例男性乳腺发育症和6例男性乳腺癌,男性乳腺发育症患者平均年龄54.1岁,男性乳腺癌患者平均年龄57.5岁。10例男性乳腺发育症病灶触之柔软;余3例男性乳腺发育症及所有6例男性乳腺癌触之质硬,活动度差。2例男性乳腺癌初诊时即有乳头血性溢液,5例男性乳腺癌皮肤局限性或弥漫性皮肤增厚,3例伴乳头内陷。13例男性乳腺发育症患者皮肤无任何改变。1例男性乳腺癌患者其母亲有乳腺癌病史。结果:3例男性乳腺发育症表现为乳晕下区不规则肿块影,边缘不光整;其余10例均表现为中心性生长的非对称性局灶性致密影。6例男性乳腺癌均表现为单纯肿块,边界清晰锐利。其中2例为分叶形;4例为不规则形,见短毛刺。5例男性乳腺癌的乳房皮肤局限性增厚,4例乳头内陷,1例合并细小多形性钙化,局部供血血管增粗,腋窝淋巴结肿大。1例男性乳腺发育症和6例男性乳腺癌在超声上均显示为实性低回声团;其余11例男性乳腺发育症表现为腺体样回声。结论:男性乳腺发育症大部分表现为腺体样致密影,少见情况下可为孤立性结节或肿块,需与不伴特征性钙化的男性乳腺癌鉴别,超声二维成像和弹性成像可作为很好的补充。
Objective: To explore the X-ray and ultrasonic features of male breast development and male breast cancer. Methods: From Mar. 2007 to Dec. 2017, 13 cases of male breast development(mean age of 54.1 years) and 6 cases of male breast cancer(mean age of 57.5 years) were chosen. The lesions in 10 cases of male breast development were soft, and in 3 cases of male breast development and 6 cases of male breast cancer were hard. Among 6 cases of male breast cancer, 2 had nipple discharge, 5 had local or diffuse skin thickening, 3 had crater nipple. No changes were observed in 13 patients with male breast development. The mother of one male breast cancer case had a history of breast cancer. Results: Three cases of male breast development showed irregular mass with non-sharp edges in the lower areola. The other 10 cases were characterized by non-symmetrical focal density shadows with centric growth. All six cases of male breast cancer had simple lumps with clear boundary and sharp edges, and 2 were leafshape, 4 were irregular with short burrs. There were 5 cases of male breast cancer with skin thickening of the breast, 4 with crater nipple, and 1 with fine polymorphous calcifications, thickened local blood vessels and axillary lymph node enlargement. Ultrasound showed low-echo mass in 1 case of male breast development and 6 cases of male breast cancer. The other 11 cases of male breast development were characterized by gland-like echoes. Conclusion: Mostmale breast development is characterized by gland-like density shadows, but rare cases could provide isolated nodules or masses, which should be distinguished from male breast cancer without characteristic calcifications. Two-dimensional ultrasound imaging and elastic imaging can be served as a good complement.
Objective: To explore the X-ray and ultrasonic features of male breast development and male breast cancer. Methods: From Mar. 2007 to Dec. 2017, 13 cases of male breast development(mean age of 54.1 years) and 6 cases of male breast cancer(mean age of 57.5 years) were chosen. The lesions in 10 cases of male breast development were soft, and in 3 cases of male breast development and 6 cases of male breast cancer were hard. Among 6 cases of male breast cancer, 2 had nipple discharge, 5 had local or diffuse skin thickening, 3 had crater nipple. No changes were observed in 13 patients with male breast development. The mother of one male breast cancer case had a history of breast cancer. Results: Three cases of male breast development showed irregular mass with non-sharp edges in the lower areola. The other 10 cases were characterized by non-symmetrical focal density shadows with centric growth. All six cases of male breast cancer had simple lumps with clear boundary and sharp edges, and 2 were leafshape, 4 were irregular with short burrs. There were 5 cases of male breast cancer with skin thickening of the breast, 4 with crater nipple, and 1 with fine polymorphous calcifications, thickened local blood vessels and axillary lymph node enlargement. Ultrasound showed low-echo mass in 1 case of male breast development and 6 cases of male breast cancer. The other 11 cases of male breast development were characterized by gland-like echoes. Conclusion: Mostmale breast development is characterized by gland-like density shadows, but rare cases could provide isolated nodules or masses, which should be distinguished from male breast cancer without characteristic calcifications. Two-dimensional ultrasound imaging and elastic imaging can be served as a good complement.
引文
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[2]陈星宇.男性乳腺癌和女性乳腺癌配对资料的临床病理特征及预后分析[D].中国优秀硕士学位论文,2014,10.
[3]STARUCH R M T,ROUHANI M J,ELLABBAN M.The surgical management of male breast cancer:time for an easy access national reporting database?[J].Ann Med Surg,2016,9(4):41-49.
[4]DONEGAN W L.Cancer of the breast in men[J].CA Cancer J Clin,1992,41:339-354.
[5]HECHT K S,ROSEN P P,SCHOTTENFELD D,et al.Male breast cancer.A clinicopathologic study of 97 cases[J].Ann Surg,1978,188:60-65.
[6]鲁英,刘佩,唐金海.男性乳腺癌的研究现状[J].中国肿瘤外科杂志,2017,8(9):264-272。
[7]白佳媛,何之彦.男性乳腺肿块的乳腺X线分析及其临床意义[J].中国医学计算机成像杂志,2014,20(4):321-324.
[8]朱永霞,燕小朋,李梅.男性乳腺发育症钼靶X线分析[J].中国全科医学,2010,8(4):501-502.