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Delineating Extramammary Findings
at Breast MR Imaging
Autores: Yiming Gao, MD; Opeyemi Ibidapo, MD; Hildegard K. Toth, MD; Linda Moy, MD
Se analiza una serie de 6 pacientes en forma retrospectiva portadores de masas pulmonares con contacto parietal, que fueron pasibles de ser puncionados bajo método ecográfico por vía percutánea, con el objetivo de arribar a un diagnóstico anatomo-patológico.
Se enfatiza el rol de ésta técnica de imagen en pacientes seleccionados, analizando los resultados obtenidos, destacando de la misma su accesibilidad y la no utilización de radiaciones ionizantes.
El rendimiento diagnóstico obtenido fue excelente, lográndose en todos los casos arribar a una muestra de tejido suficiente para su análisis, sin un incremento de las complicaciones del procedimiento.
Palabras clave Tórax, Biopsia, Ultrasonido, Diagnóstico.
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English: |
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Breast magnetic resonance (MR) imaging is the only breast imaging
modality that consistently encompasses extramammary structures
in the thorax and upper abdomen. Incidental extramammary
findings on breast MR images of patients with a history of breast
cancer or other malignancies are significantly more likely to be malignant
and may affect staging and treatment. An understanding of
the frequency, distribution, and context of extramammary findings
on breast MR images and a familiarity with common and uncommon
sites of breast cancer metastasis inform the differential diagnosis
and prompt the appropriate diagnostic next step, to differentiate
benign from malignant findings. High-yield organ systems on breast
MR images, as reflected by a high positive predictive value for malignancy,
are correlated with known distant sites of breast cancer
metastasis in the bone, lung, liver, and lymph nodes. Staging is
considered when disease involves the skin and chest wall. Unusual
sites of breast cancer metastasis from invasive lobular carcinoma
are discussed, including the gastrointestinal tract, peritoneum, and
adrenal glands. Nonmalignant clinically important findings involving
the cardiovascular and gastrointestinal systems are reviewed,
and potential pitfalls in diagnosis and interpretation are highlighted.
A consistently systematic diagnostic approach is emphasized for
identifying extramammary abnormalities on breast MR images. All
things considered, the radiologist should be able to improve diagnostic
sensitivity and specificity while interpreting extramammary
findings on breast MR images.
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