| 潘峰,彭媛,陈定宝,李安琪.乳腺原发性血管肉瘤临床、MRI及病理表现[J].中国介入影像与治疗学,2026,23(6):351-354 |
| 乳腺原发性血管肉瘤临床、MRI及病理表现 |
| Clinical, MRI and pathological findings of primary breast angiosarcoma |
| 投稿时间：2026-04-08 修订日期：2026-05-25 |
| DOI：10.13929/j.issn.1672-8475.2026.06.006 |
| 中文关键词: 乳腺肿瘤 血管肉瘤 磁共振成像 |
| 英文关键词:breast neoplasms hemangiosarcoma magnetic resonance imaging |
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| 中文摘要: |
| 目的 观察乳腺原发性血管肉瘤（PBA）临床、MRI及病理表现。方法 回顾性分析5例经病理证实的女性PBA患者，观察其临床、MRI及病理表现。结果 5例临床均表现乳腺无痛包块进行性增大，病程2个月～3年，4例单发、1例为双乳多发PBA合并右乳导管原位癌；MRI多表现为卵圆形、边界清晰包块，平均最大径（6.21±2.37）cm，均呈T1WI等信号、T2WI及弥散加权成像高信号；增强后多表现为快速明显“向心性填充”强化并见血窦样结构，时间-强度曲线均呈平台型或廓清型；无坏死、瘤周水肿及皮肤或胸大肌受累。免疫组织化学多为三阴性表型，CD31、CD34及ERG均呈阳性。结论 PBA临床表现为乳腺无痛包块进行性增大；MRI表现主要包括内部血窦结构及“向心性填充”式强化，多无坏死及淋巴结/远处转移；免疫组织化学三阴性表型及血管内皮标志物（CD31、CD34、ERG）阳性有助于诊断与鉴别诊断。 |
| 英文摘要: |
| Objective To observe the clinical， MRI and pathological findings of primary breast angiosarcoma （PBA）. Methods Five female PBA patients were retrospectively enrolled， and the clinical， MRI and pathological findings were analyzed. Results All 5 cases presented as progressively enlarged painless breast masses， with disease duration ranged from 2 months to 3 years. Solitary breast lesion was found in 4 cases， while bilateral multiple PBA complicated with ductal carcinoma in situ of the right breast were detected in 1 case. MRI predominantly revealed oval masses with well-defined borders， with a mean maximum diameter of （6.21±2.37）cm. All lesions showed isointense signals on T1WI， hyperintense signals on T2WI and diffusion weighted imaging. After administration of contrast agents， most lesions demonstrated rapid and marked "centripetal filling" enhancement with intralesional sinusoid-like structures. The time-intensity curves of PBA lesions were plateau or washout type， without necrosis， peritumoral edema nor involvement of the skin and pectoralis major muscle. Immunohistochemistry revealed a predominantly triple-negative phenotype， with positive CD31， CD34 and ERG in all 5 cases. Conclusion PBA presented as progressively enlarged painless breast masses， with characteristic MRI findings mainly included intralesional sinusoidal structures and "centripetal filling" enhancement， generally without necrosis， lymph node metastasis and distant metastasis. Triple-negative immunohistochemical phenotype together with positive vascular endothelial markers （CD31， CD34， ERG） facilitated diagnosis and differential diagnosis of PBA. |
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