By Catherine M. Appleton

ISBN-10: 0199731926

ISBN-13: 9780199731923

Finished and to-the-point, Breast Imaging Cases covers the sector of breast imaging for the radiology resident and practitioner. a brand new addition to the Cases in Radiology sequence, this e-book follows the transparent and ordinary structure of challenge and answer, offered in a hundred specific circumstances. that includes over four hundred photos, this example publication examines the spectrum of universal scientific concerns in breast imaging, together with vintage and often encountered diagnoses, in addition to infrequent findings. circumstances are geared up so as of accelerating hassle to facilitate studying and problem the reader to probe extra. below exam are the gamut of cysts, calcifications, benign plenty, and carcinomas present in breast imaging. The final portion of circumstances is devoted to breast MR. each one case is whole with correct findings, differential diagnoses, administration, and large instructing points.

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ACR Breast Imaging Reporting and Data Systems, Breast Imaging Atlas. Reston, VA. American College of Radiology, 2003:60-61. Berg W, et al. Diagnostic Imaging Breast. , 2006:35-39. Stavros AT. Breast Ultrasound. Philadelphia: Lippincott Williams & Wilkins, 2004:276-350. 40 Case 20 History ▶ Painful, erythematous mass in the left breast, upper outer quadrant. The patient reports malaise and low-grade fever for 2 days 41 Case 20 Abscess Axilla 42 Findings ▶ Mammogram ■ Increased soft tissue density and an obscured mass at the 2 o’clock position (skin BB marker) ■ Trabecular thickening, skin thickening (arrowheads), and axillary adenopathy (arrows) ▶ Ultrasound: ■ Irregular, heterogeneously hypoechoic mass with a thickened rim and posterior acoustic enhancement ■ During real-time scanning, some mobile internal debris was evident.

Philadelphia: Elsevier Mosby, 2004:81. 46 Case 22 History ▶ Palpable mass left breast, upper outer quadrant (metallic BB) 47 Case 22 Lipoma Findings ▶ Mammogram: Oval/lenticular, circumscribed, fat-density, superficial mass (arrowheads) ▶ Ultrasound: Parallel homogenous mass with echotexture identical to surrounding fat (arrowheads) ▶ Clinical exam demonstrates a non-tender, soft, mobile mass Differential Diagnosis ▶ Classic appearance demonstrated ▶ Hamartoma (fibroadenolipoma) may mimic lipoma when scant fibroglandular elements are present Teaching Points ▶ May occur anywhere in the breast ■ Most arise within the subcutaneous fat layer ■ Less often within the retroglandular fat ▶ Mammogram appearance ■ Radiolucent/fat-density mass with thin radiopaque capsule ◆ Capsule may or may not be visible ■ Tangent mammographic view may depict the mass to better advantage ▶ Ultrasound appearance ■ Ultrasound typically not warranted ■ Variable: isoechoic to mildly hyperechoic relative to adjacent fat lobules ■ Capsule may or may not be visible Management ▶ BI-RADS® Category 2: Benign finding ▶ Annual screening mammography Selected References/Further Reading Bassett LW, et al.

20 Case 11 History ▶ Screening mammogram 21 Case 11 Fibroadenolipoma (Hamartoma) Findings ▶ There is a large encapsulated mass in the lower inner quadrant (arrowheads) containing both fat and glandular elements (“breast within a breast” or “cut-sausage” appearance) Differential Diagnosis ▶ None—classic appearance demonstrated Teaching Points ▶ ▶ ▶ ▶ Typically incidental finding, but rarely presents as a palpable mass When sparse fat components are present, fibroadenoma may be suspected “Don’t touch” lesion when classic features are present Ultrasound rarely required but can demonstrate heterogeneous glandular and fat components, with a thin echogenic pseudocapsule ▶ Other common fat-containing breast masses include: ■ Lipoma ■ Galactocele ■ Intramammary lymph node ■ Oil cyst Management ▶ BI-RADS® Category 2: Benign finding ▶ Annual screening mammography Selected References/Further Reading American College of Radiology (ACR).

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Breast Imaging Cases (Cases in Radiology) by Catherine M. Appleton

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