• Non ci sono risultati.

133 CASO 3

Fig.1a Mammografia: Area di distorsione del QS dx

134 Ecotomografia mammaria: mancato riscontro ecografico della lesione

Biopsia Mammaria stereotassica (Mammotome).: sull‟area di distorsione del QS dx

135 RISONANZA MAGNETICA

Fig.3 MIP in assiale. Area di enhancement nodulare irregolare a livello del QSI (34x29x25mm)

136

Fig.4 MIP in sagittale. Irregolare enhacement nodulare al QSI destro

137 Fig.6 Curva di tipo 2(plateu)

RMM:

Area di enhancement nodulare irregolare a livello del QSI (34x29x25mm) con curva II. (RM3)

Istologia definitiva: Adenosi sclerosante

138 CASO 4

Fig.1 Mammografia (proiezione obliqua sinistra) : Presenza di cluster multipli di microcalcificazioni M3 tra le h 2 e le h 4

139 Fig.2 Ecotomografia mammaria: quadro complesso di displasia con cisti e noduli solidi ovunque. Reperti di aspetto ecografico benigno (U2)

Biopsia Mammaria stereotassica (Mammotome) sul cluster di microcalcificazioni di sinistra tra le h 2 e le h 4.

140 RISONANZA MAGNETICA

Fig.3 MIP in coronale. Apprezzabile area nodulare centimetrica alle h 2 a destra, micronodularità millimetrica diffusa, h 6 a sinistra nodularità .

141 Fig.5 MIP in assiale.

142 Fig.6 curva di tipo II(plateu)

Fig.6 Immagini T1 postcontrastografica in coronale sinistra

143 Fig.7 curva di tipo III( rapido wash out)

RMM:

Presenza di micronodularità millimetrica diffusa. Area nodulare centimetrica alle h 2 a destra con curva di tipo II. Alle h 6 a sinistra nodularità con curva di tipo III. (RM3)

Istologia definitiva: Iperplasia duttale atipica

144 BIBLIOGRAFIA

1. Bazzocchi M, Guerrieri A, Fabris G. Forme in situ e lesioni proliferative mammarie: metodiche a confronto. 43° Congresso Nazionale SIRM 2008, La radiologia medica, pag.153-154. Suppl. Vol.113. Maggio 2008.

2. Liberman L. Clinical management issue in percutaneos core breast biopsy. Radiology. 2000 Jul; 38(4):791-807.

3. Dillon MF, McDermott EW, Hill AD, O‟Doherty A, O‟Higgins N, Quinn CM. Predictive value of breast lesions of “uncertain malignant potential” and “suspicious for malignancy” determined by needle core biopsy. Ann. Surg. Oncol. 2007 Feb; 14(2):704-711.

4. Bianco A R. Manuale di oncologia clinica. pag. 44, 109- 111. McGraw-Hill, III

edizione, 2003.

5. Berrino F, Micheli A. Ormoni, fattori costituzionali, dieta e carcinoma mammario. Attualità in senologia. 2005 (44):12- 21. Istituto nazionale per lo studio e la cura dei tumori, Milano.

6. Parker SH, Burbank F, Jackman RJ, Aucreman CJ, Cink TM, Coscia JL Jr, Eklund GW, Evans WP, Garver PR, et al. Percutaneus large-core brest biopsy: a multy-institutional study. Radiology. 1994 Nov;193(2): 359-364.

145 7. Houssami N, Ciatto S, Ellis I, Ambogetti D. Underestimation of malignancy of breast core- needle biopsy: concepts and precise overall and category-specific estimates. Cancer. 2007; Feb 1;109 (3): 487-495.

8. Nonni A, Zagouri F, Sergentanis TN, Lazaris AC, Patsouris ES, Zografos GC. Immunohistochemical expression of estrogen receptors alpha and beta in lobular neoplasia. Virchows Arch. 2007 Nov;415 (5): 893-897.

9. Robbins. Le basi patologiche delle malattie., vol. 2, pag. 1277-1278,1280-1282, 1288. Piccin, VI edizione, 2000.

10. Oprić D, Fajdić J, Hrgović Z, Granić M, Milosević Z, Gugić D, Oprić S, Babić D, Fassbender WJ. Radial scar of the breast-a confusing lesion. Adv Med Sci. 2007;52:257-61.

11. Datrice N, Narula N, Maggard M, Butler J, Hsiang D, Baick C, Lane K. Do breast columnar cell lesions with atyptia need to be excise? Am surg. 2007 Oct; 73 (10): 984-986.

146 12. Berardi L ,Latin A, Santinelli N, Herber S,

Baldassarre A, Scartozzi F, and Cellerino F. Mucocele-Like Tumour of the Breast.J. Exp. Clin. Cancer Res., 2003; 60: 22, 2.

13. Tavassoli FA. Pathology of the breast. 2nd Edition. Stamford, Appleton and Lang, 1999 pag.93-97,107-109,160-190,194-209,263-

285,445,442-460.

14. Feeley L, Quinn CM. Columnar cell lesions of the breast. Histopathology. 2008 Gen 52(1):11-9

15. Cittadini G. Diagnostica per immagini e radioterapia. pag. 135-136, 794-804 ECIG, V edizione, 2003.

16. Shiraishi A. Current state of digital mammography. Breast Cancer. 2008;15(3):194-9

17. SH Parker, WE Jobe, MA Dennis, AT Stavros, KK Johnson, WF Yakes, JE Truell, JG Price, AB Kortz and DG Clark. US-guided automated large-core breast biopsy Radiology, 1993 Vol 187, 507-511.

147 18. EL Elvecrog, MC Lechner and MT Nelson. Nonpalpable breast lesions: correlation of stereotaxic large-core needle biopsy and surgical biopsy results. Radiology 1993 Vol. 188, 453-455.

19. Kuhl CK. Current Status of Breast MR Imaging. Part I. Choice of technique, image interpretetation, diagnostic accuracy, and transfer to clinical practice. Radiology 2007; 244: 356- 378. Part II. Clinical Applications. Radiology 2007; 244: 672-669.

20. Baum F, Fischer U et al. Classification of hypervascularized lesions in CE MR imaging of the breast. Eur Radiol 2002 12: 1087-1092.

21. Sardanelli F,Iozzelli A, Fausto A. MR imaging of the breast:indications, estabilished technique, and new directions. Eur Radiol. 2003 Nov; 10(11):1733-1736.

22. Tardivon AA et al. Breast imaging and reporting data system (BIRADS): Magnetic resonance imaging. EJR 2007 (61): 212-215.

23. Peters NH, Borel Rinkes IH, Zuithoff NP, Mali WP, Moons KG, Peeters PH. Meta-analysis of MR

148 imaging in the diagnosis of breast lesions. Radiology. 2008 Gen;246(1):116-124.

24. Neubaue H, Kuehne-Heid M Li, Schneider A. High grade and non-grade dutal carcinoma in situ on dynamic MR mammography;characteristic finding for signal increase and morphologic pattern of enhacement. Br J Radiol 76 (2003): 3- 12.

25. Margenthaler JA, Duke D, Monsees BS, Barton PT, Clark C, Dietz JR. Correlation between core biopsy and excisional biopsy in breast high-risk lesions. Am J Surg. 2006 Oct;192(4):534-537.

26. Zuiani C, Londero V, Bestagno A, Puglisi F, Di Loreto C, Bazzocchi M. Proliferative high-risk lesions of the breast: contribution and limits of US-guided core biopsy. Radiol Med (Torino). 2005 Nov-Dec;110(5-6):589-602.

27. Jacobs TW, Connolly JL, Schnitt SJ. Nonmalignant lesions in breast core needle biopsies: to excise or not to excise? Am J Surg Pathol. 2002 Sep;26(9):1095-110.

28. Mahoney MC, Robinson-Smith TM, Shaughnessy EA. Lobular neoplasia at 11-gauge vacuum- assisted stereotactic biopsy: correlation with

149 surgical excisional biopsy and mammographic follow-up. AJR Am J Roentgenol. 2006 Oct;187(4):949-54.

29. Jackman RJ, Birdwell RL, Ikeda DM. Atypical ductal hyperplasia: can some lesions be defined as probably benign after stereotactic 11-gauge vacuum-assisted biopsy, eliminating the recommendation for surgical excision? Radiology. 2002 Aug;224(2):548-554

30. Liberman L, Tornos C, Huzjan R, Bartella L, Morris EA, Dershaw DD. Is surgical excision warranted after benign, concordant diagnosis of papilloma at percutaneous breast biopsy? AJR Am J Roentgenol. 2006 May;186(5):1328-1334.

31. Golub RM, Bennet CL, Stinson T, Venta L, Morrow M. Cost minimization study of image- guided core needle biopsy versus surgical excisional biopsy for woman with abnormal mammograms. J Clin Oncol.2004 Jun 15;22(12):2430-2437.

32. Pediconi F, Occhiato R, Venditti F, Fraioli F, Napoli A, Votta V, Laghi A, Catalano C, Passariello R. Radial scars of the breast: contrast-

150 enhanced magnetic resonance mammography appearance. Breast J. 2005 Jan-Feb;11(1):23-28.

33. Daniel BL, Gardner RW, Birdwell RL, Nowels KW, Johnson D. Magnetic resonance imaging of intraductal papilloma of the breast. Magnetic Resonance Imaging. 2003 Oct;21(8):887-892.

34. Krämer SC, Rieber A, Görich J, Aschoff AJ, Tomczak R, Merkle EM, Müller M, Brambs HJ. Diagnosis of papillomas of the breast: value of magnetic resonance mammography in comparison with galactography. Eur Radiol. 2000;10(11):1733-6.

35. Linda A. et al. Borderline breast lesions diagnosed at core needle biopsy: can magnetic resonance mammography rule out associated malignancy? Preliminary results based on 79 surgically excised lesions. Breast. 2008 Apr;17(2):125-31

36. Sardanelli F., Houssami N., Evalutation oflesions of uncertain malignant potential (B3) at core needle biopsy using magnetic resonance imaging: A new approach warrants prospective studies. Breast. 2008 Feb 7;117-119

Documenti correlati