2.4 Other
Case 17：female，40 years old，has been found left breast mass for more than 1 month.Specialized examination：the left breast outer quadrant can touch the mass，with hard quality，unclear boundary，and mobility.
Fig.A Solid hypoechoic lesion
Fig.B The shape is still regular and the local edge is fuzzy
Fig.C RI：0.57
Fig.D Alder grade 3
Fig.E The elasticity score is 3 to 4
Analysis and differential diagnosis：Left breast of middle-aged woman can touch hard mass.Ultrasonic manifestations：solid hypoechoic lesion with regular shape，rough local edge and no change in posterior echo，CDFI：abundant blood flow signals can be seen in it，RI：0.57，Alder grade 3，elasticity score：3 to 4.Solid hypoechoic lesion of left breast has no obvious boundary and capsule.We need to exclude the possibility of fibroadenoma.The lesion is hypoechoic，with rough edges and abundant internal blood flow.Malignant lesions may not be excluded.
Pathological results：Pathology suggests medullary carcinoma of breast.
Case 18：female，17 years old，chest pain lasts for more than 8 months and worsens for 1 week.Specialized examination：mass on both breasts，hard quality，unclear boundary，poor mobility，no swelling and ulceration，bilateral axillary and supraclavicular lymph nodes have no swelling.
Fig.A hypoechoic lesion
Fig.B Disordered structure
Fig.C Irregular shape，unclear boundary
Fig.D The lesions are significantly different from normal glands(https://www.daowen.com)
Fig.E Alder grade 2
Fig.F RI：0.78
Fig.G The elasticity score is 4 points.
Analysis and differential diagnosis：young unmarried woman's breast can touch hard mass.U1-trasonography：Bilateral mammary glands have multiple abnormal echo areas with disordered structure.Glands in some areas are distorted，irregular in shape，unclear in boundary，hypoechoic in interior and unchanged in rear echo.CDFI：Rich blood flow signals can be seen in it，RI：0.78，Alder grade 3，elasticity score：4.The patient is an unmarried woman，and there is no red swelling and hot pain in both mammary glands.Mastitis can be ruled out.Multiple abnormal echo areas in bilateral mammary glands are scattered in normal mammary glands.The texture of abnormal echo region is hard.Shape boundary is different from normal gland.Blood flow is richer than normal glands.Dysplasia disorder may be excluded.There is no obvious boundary and capsule in the double breast multiple abnormal echo region，the internal echo is uneven and the mobility is poor.The possibility of fibroadenoma can be excluded.Combined with the above signs，bilateral intramammary lesions should tend to exclude malignant possibility.
Pathological results：The patient has underwent ultrasound-guided biopsy.Pathology shows malignant tumor，combined with HE and immunohistochemical results.It conforms to myeloid sarcoma/leukemia.
Case 19：female，46 years old，has been found left breast mass for more than 2 months.Specialized examination：The upper quadrant of the left breast can touch the mass，which is hard and has unclear boundary and can move freely.
Fig.A hypoechoic lesion
Fig.B Shape is fuzzy and irregular，edge
Fig.C RI：0.44
Fig.D Alder grade 2
Fig.E The elasticity score is 3 points
Analysis and differential diagnosis：left breast of middle-aged woman can touch hard mass.Ultrasonic manifestations：solid hypoechoic lesion with irregular shape，rough edge，hypoecho inside and no change in rear echo.Pressurized exploration can find the focus deformation.CDFI：Rich blood flow signals can be seen in it，RI：0.44，Alder grade 2，elasticity score：3.The patient is a middle-aged woman，the left breast has no red swelling and pain，and mastitis can be ruled out.Solid hypoechoic lesionof left breast has no obvious boundary and capsule，internal echo is uneven，mobility is poor，and fibroadenoma may be excluded.The lesion is hypoechoic，with unclear margin and abundant internal blood flow.Malignant lesions may not be excluded.
Pathological results：The patient has underwent ultrasound-guided puncture biopsy.Pathology shows lymphoma and tends to diffuse large B lymphoma.
（Dong Chen，Xianmao Luo，Zhiyao Li，Haitao Chen）