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目的探讨原发性乳腺淋巴瘤(primary breast lymphoma,PBL)误诊原因及减少误诊的方法。方法回顾性分析14例术前误诊PBL患者乳腺彩超、乳腺钼靶X线、乳腺CT、手术组织病理等资料。结果 14例中以腋窝淋巴结肿大就诊2例,以皮肤红肿疑似乳腺炎就诊2例,以乳腺无痛性肿块就诊10例;术前误诊乳腺癌11例,乳腺炎性病变2例,乳腺纤维瘤1例;14例均行乳腺彩超检查,10例考虑乳腺癌,4例考虑乳腺纤维瘤;11例行乳腺钼靶X线检查,8例考虑恶性,3例考虑良性;7例行CT检查,1例考虑乳腺纤维瘤,3例考虑乳腺癌,1例考虑乳腺增生,2例考虑炎性病变但不排除炎性乳腺癌;术前误诊为乳腺癌11例,乳腺炎性病变2例,乳腺纤维瘤1例;14例均行手术治疗,术后组织病理及免疫组织化学检查证实为PBL,均为B系非霍奇金淋巴瘤。结论 PBL临床表现及影像学表现缺乏特异性,术前易误诊,确诊需依据组织病理及免疫组织化学检查。
Objective To investigate the causes of misdiagnosis of primary breast lymphoma (PBL) and to reduce the misdiagnosis method. Methods A retrospective analysis of 14 cases of preoperative misdiagnosis of PBL breast mammography, mammography mammography, breast CT, surgical histopathology and other data. Results Of the 14 cases, 2 cases were treated with axillary lymph node enlargement, 2 cases were treated with suspected skin mastitis, 10 cases were treated with painless mass of breast, 11 cases were misdiagnosed as breast cancer, 2 cases were mastitis lesions, 1 case of tumor, 14 cases of breast cancer, 10 cases of breast cancer, 4 cases of breast fibroids, 11 cases of breast molybdenum target X-ray examination, 8 cases of malignancy, 3 cases considered benign and 7 cases of CT , 1 case of breast fibroids, 3 cases of breast cancer, 1 case of mammary gland hyperplasia, 2 cases of inflammatory lesions but not of inflammatory breast cancer; 11 cases of preoperative misdiagnosis as breast cancer and 2 cases of mastitis, 1 case of breast fibroma; 14 cases underwent surgical treatment. Postoperative histopathology and immunohistochemistry confirmed PBL, all of which were B-line non-Hodgkin’s lymphoma. Conclusions The clinical manifestations and imaging findings of PBL are lack of specificity. They are easily misdiagnosed before operation and confirmed by histopathology and immunohistochemistry.