Mucinous Carcinoma of the Breast: Imaging Features and Pathological Correlation
ACW Lee, JWC Wai, OY Cheung, LF Chiu, YW Tsang, HHC Tsang, WS Fok, HN Wong, JCM Sitt, SS Cheng, JB Chiang, KW Tang
Hong Kong J Radiol 2018;21:25-33
DOI: 10.12809/hkjr1616821
Objective: To review the imaging features of mucinous carcinoma of the breast, a rare subtype of ductal carcinoma of the breast.
Methods:Clinical data; mammographic, ultrasonographic, and magnetic resonance imaging features; and histological findings from patients diagnosed with mucinous carcinoma of the breast at the Queen Elizabeth Hospital, Hong Kong, from January 2005 to July 2016 were reviewed.
Results: A total of 11 cases of mucinous carcinoma of the breast were identified. Of the eight available mammography studies, all detected masses, with seven showing high density and one equal density; five masses had a circumscribed margin and none showed malignant calcification. All 11 mucinous carcinomas were detected on ultrasound scans, mostly as oval or round masses. For all five patients with complete magnetic resonance imaging records, mucinous carcinomas were detected as oval masses. All five lesions had hypointense signals on T1-weighted images and hyperintense signals on T2-weighted sequences, owing to the presence of extracellular mucin. According to histological analysis, seven cases were pure-type mucinous carcinoma and four were mixed-type mucinous carcinoma.
Conclusion: Mucinous carcinoma of the breast is readily detected by mammography and ultrasonography. These lesions commonly appear as circumscribed masses on both mammography and ultrasonography. On magnetic resonance imaging, they typically show hyperintense signals on T2-weighted sequence. Correlation with histopathologic findings assists in arriving at the diagnosis and guiding further management.
中文摘要
黏液型乳腺癌：影像學表現與病理相關性分析
李昭穎、衛莊、張靄怡、趙朗峰、曾奕桓、曾凱晴、霍泳珊、王馨藝、薛靜雯、鄭珊珊、 蔣碧茜、鄧國穎
目的：回顧黏液型乳腺癌這種罕見亞型乳腺管癌的影像學特點。
方法：回顧2005年1月至2016年7月期間在香港伊利沙伯醫院確診黏液型乳腺癌的患者其臨床資料， 以及乳腺X光、超聲檢查、磁共振成像和組織學檢查結果。
結果：研究共包括11例黏液型乳腺癌。在8個現有乳房X光片中，全部均檢測出腫塊；7例屬高密 度、1例屬等密度。5例為邊緣清晰的腫塊，均未見惡性鈣化。這11例黏液型乳腺癌均透過超聲檢查 測出，大多為橢圓形或圓形腫塊。在5名有完整磁共振成像記錄的患者中，黏液型乳腺癌均呈橢圓 形。由於存在細胞外黏蛋白，以上5個病灶均在T1加權像上呈低信號，T2加權像上則呈高信號。根 據組織學檢查分析，7例為純型黏液型乳腺癌，其他4例則為混合型黏液型乳腺癌。
結論：乳腺X光和超聲檢查均能檢出黏液型乳腺癌，而且通常顯示為邊緣清晰的腫塊。磁共振成像 通常在T2加權序列呈現高信號。與組織病理組織學結果的相關性有助確診並指導進一步治療。