RESUMO
OBJECTIVE: Breast MRI is used to screen high-risk patients and determine extent of disease in breast cancer (BC) patients. The goal of this study was to determine the pathologic correlates of breast MRI abnormalities biopsied under MRI guidance. METHODS: We retrospectively identified 101 MRI-guided core needle biopsies (CNB) of the breast from 79 women over a 4-year period. MRI-detected lesions biopsied with ultrasound or stereotactic guidance were excluded. MRI studies and pathology were reviewed by breast radiologists and pathologists. RESULTS: Of the 79 patients, 72 (91%) had a history of prior (n = 13) or concurrent (n = 59) BC. There were 101 MRI abnormalities: 60 (59%) with non-mass enhancement (NME) and 41 (41%) with mass enhancement. Pathology was benign in 83/101 (82%), including in the majority of NME lesions (43/60, 72%). The most common benign findings were: fibrocystic changes (FCC) (49%), sclerosing lesions (13%), and fibroadenoma (FA) (9%). There were 18 (18%) malignant diagnoses: 8 (44%) invasive lobular carcinoma (ILC), 7 (39%) ductal carcinoma in situ (DCIS), and 3 (17%) invasive ductal carcinoma (IDC). Of the 18 malignant diagnoses, 16 (89%) occurred in 14 unique patients with concurrent BC. Based on the malignant MRI-guided CNB, 6 (46%) of these patients had additional (sentinel lymph node biopsy or contralateral breast surgery) or more extensive (wider lumpectomy) surgery. CONCLUSION: In this series, most MRI-guided CNB of the breast were benign. The vast majority of malignant diagnoses occurred in patients with concurrent BC and frequently resulted in changes in clinical management.
Assuntos
Biópsia com Agulha de Grande Calibre/instrumentação , Mama/diagnóstico por imagem , Mama/patologia , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Biópsia Guiada por Imagem/métodos , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Neoplasias/cirurgia , Administração dos Cuidados ao Paciente/métodos , Administração dos Cuidados ao Paciente/tendências , Radiologia , Estudos Retrospectivos , Índice de Gravidade de DoençaAssuntos
Carcinoma de Apêndice Cutâneo/diagnóstico , Neoplasias de Cabeça e Pescoço/secundário , Neoplasias Cutâneas/secundário , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Neoplasias das Glândulas Sudoríparas/patologia , Idoso de 80 Anos ou mais , Alphapapillomavirus/isolamento & purificação , Biópsia/métodos , Carcinoma de Apêndice Cutâneo/patologia , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Diagnóstico Diferencial , Feminino , Humanos , Linfadenopatia/patologia , Pescoço/patologia , Terapia Neoadjuvante/métodos , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/patologia , Pele/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/virologia , Resultado do TratamentoRESUMO
HIV infection is associated with an increased risk for developing B-cell lymphoproliferative disorders. The spectrum of disease differs in HIV-infected versus HIV-uninfected persons, with aggressive B-cell non-Hodgkin lymphomas constituting a higher proportion of all lymphoproliferative disorders in the HIV-positive population. Although antiretroviral therapy (ART) has significantly changed the landscape of lymphomas arising in HIV-infected persons, population growth and aging are reflected in the steady increase in non-AIDS-defining cancers. In the ART era, outcomes for HIV-infected lymphoma patients are similar to those of HIV-negative patients. This article reviews the diagnostic features and summarizes current biologic understanding of HIV-associated lymphomas.