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目的总结乳腺原发性鳞状细胞癌临床超声及病理特征。方法对7例1995年1月至2014年12月北京协和医院临床收治并经超声及手术病理检查证实为乳腺原发性鳞状细胞癌患者的临床、病理及超声声像图特征进行总结分析。结果 7例乳腺原发性鳞状细胞癌患者8个乳腺原发灶中单发6例,多发1例;大小7.0~60.0 mm,平均大小(34.0±19.6)mm;其中6个呈实性低回声,2个呈囊实性混合回声;8个原发灶形态均不规则、边界模糊;2个出现点状及条状钙化。彩色多普勒血流成像示7个原发灶血流丰富(Ⅱ或Ⅲ级),1个原发灶未见血流(0级)。术后病理大体标本示8个乳腺肿物中实性6个,颜色灰白,质中,边界不清;2个肿物内部分呈囊腔样。1例70岁老年患者乳腺癌根治术后胸壁多次复发,超声显示胸壁复发灶呈厚壁无回声;2个胸壁复发灶大体标本示肿物均呈囊腔,囊壁厚,镜检示纤维脂肪及骨胳肌组织内见鳞状细胞癌浸润。结论乳腺原发性鳞状细胞癌病灶较大,超声显示肿瘤内部较多囊性成分和丰富血流,对诊断乳腺原发性鳞状细胞癌有帮助。
Objective To summarize the clinical and pathological features of primary breast squamous cell carcinoma. Methods The clinical, pathological and ultrasonographic features of 7 patients with primary breast squamous cell carcinoma confirmed by ultrasound and surgical pathology from January 1995 to December 2014 in Peking Union Medical College Hospital were analyzed. Results Seven cases of primary breast squamous cell carcinoma of the breast were found in 6 cases of primary breast lesions with single disease, with a size of 7.0-60.0 mm and an average size of (34.0 ± 19.6) mm. Six of them showed low solidity Echo, 2 were mixed cystic echoes; 8 primary tumor morphology irregular, fuzzy boundaries; 2 appear punctate and strip calcification. Color Doppler flow imaging showed seven primary bloodstreams rich in blood flow (grade II or III) and no blood flow in one primary tumor (grade 0). Postoperative pathological gross specimens showed solidity in 8 breast masses 6, gray color, quality, the border is unclear; 2 tumor within the cytoplasm was kind. A case of 70-year-old elderly patients with breast cancer after radical resection of the chest wall repeatedly, ultrasound showed no recurrence of chest wall thick echo; two chest wall recurrence lesions showed the tumor showed cysts, wall thickness, microscopic examination of fibers Squamous cell carcinoma infiltration in fat and skeletal muscle. Conclusions Primary breast squamous cell carcinoma has larger lesions and ultrasound shows more cystic components and abundant blood flow inside the tumor, which is helpful for the diagnosis of primary breast squamous cell carcinoma.