纤维上皮病变（FEL）是乳腺放射科医生和病理学家最常见的乳腺肿块之一。它们涵盖一系列良性和恶性病变，包括纤维腺瘤（FA）和叶状肿瘤（PT）。 FA 通常见于年轻的绝经前女性，发病高峰在 20-30 岁，影像学特征为椭圆形局限性低回声肿块。虽然一些 FA 变异对激素影响特别敏感并且可以表现出快速生长（例如幼年 FA 和哺乳期腺瘤），但大多数简单 FA 生长缓慢并且在绝经后退化。 PT 可以是良性、交界性或恶性，在 40-50 岁的老年女性中更为常见。与 FA 相比，PT 通常表现为增大的可触及肿块，并且在成像时尺寸较大，有时形状不规则。尽管 FA 和 FA 变异体通常采用保守治疗，除非体积较大且有症状，但由于经皮活检存在采样不足的风险以及边缘性和恶性 PT 的恶性潜力，因此需要通过手术切除 PT。由于成像和组织学表现的重叠，FEL 可能给放射科医生和病理学家带来诊断挑战。放射科医生可以通过提供足够的组织样本并在活检时为病理学家提供关键信息来促进准确的诊断。了解 FEL 的频谱可以促进和指导适当的放射学病理相关性以及 PT 的及时诊断和管理。根据 CC BY 4.0 许可证发布。本文提供在线补充材料。本文的测验问题可通过在线学习中心获得。

Fibroepithelial lesions (FELs) are among the most common breast masses encountered by breast radiologists and pathologists. They encompass a spectrum of benign and malignant lesions, including fibroadenomas (FAs) and phyllodes tumors (PTs). FAs are typically seen in young premenopausal women, with a peak incidence at 20-30 years of age, and have imaging features of oval circumscribed hypoechoic masses. Although some FA variants are especially sensitive to hormonal influences and can exhibit rapid growth (eg, juvenile FA and lactational adenomas), most simple FAs are slow growing and involute after menopause. PTs can be benign, borderline, or malignant and are more common in older women aged 40-50 years. PTs usually manifest as enlarging palpable masses and are associated with a larger size and sometimes with an irregular shape at imaging compared with FAs. Although FA and FA variants are typically managed conservatively unless large and symptomatic, PTs are surgically excised because of the risk of undersampling at percutaneous biopsy and the malignant potential of borderline and malignant PTs. As a result of the overlap in imaging and histologic appearances, FELs can present a diagnostic challenge for the radiologist and pathologist. Radiologists can facilitate accurate diagnosis by supplying adequate tissue sampling and including critical information for the pathologist at the time of biopsy. Understanding the spectrum of FELs can facilitate and guide appropriate radiologic-pathologic correlation and timely diagnosis and management of PTs. Published under a CC BY 4.0 license. Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.