摘要
目的研究肉芽肿性乳腺炎的临床病理学特点,探讨其诊治方法。方法回顾性分析天津医科大学附属肿瘤医院2003年1月至2011年3月期间收治的89例肉芽肿性乳腺炎的临床病理学特征和随访资料。所有病例标本经过抗酸染色及过碘酸雪夫氏(PAS)染色。结果患者均为女性,年龄为22～57岁,平均年龄为(33.9±6.8)岁,其中85例有哺乳史,均以乳腺肿块就诊。组织病理特点为以乳腺小叶为中心的病变,呈结节状多灶性分布,小叶内可见以上皮样细胞、多核巨细胞、淋巴细胞及中性粒细胞为主的炎性细胞浸润,病变组织的切缘未见炎症细胞;所有病例抗酸染色和PAS染色未见分枝杆菌及霉菌。89例患者均选择手术治疗,手术以乳腺小叶区段切除为主,并根据患者具体情况调整术式。术后随访1～102个月,中位随访时间为74个月,仅1例复发。结论肉芽肿性乳腺炎的临床表现不易与乳腺癌鉴别,组织病理学检查是唯一确诊手段。
Objective To investigate the clinicopathological characteristics of granulomatous lobular mastitis （GM） and explore the diagnosis and treatment. Methods The clinicopathological characteristics and the follow-up data in 89 cases of GM treated in Tianjin Medical University Cancer Institute ＆ Hospital from January 2003 to March 2011 were retrospectively analyzed. All cases underwent the acid-fast staining and PAS staining. Results All patients were admitted for breast mass, female, aged from 22 to 57 years, mean （33. 9±6. 8） years, including 85 patients with history of breast feeding. Histopathology showed the lesions centered at lobules with nodular muhifocal distribution, infiltration of inflammatory cells in breast lobules （ most were epithelioid ceils, muhinucleated giant ceils, lymphocytes and neutrophils）, but no inflammatory cells in the margin of resected tissues. No mycobacterium and mycetes were observed in anti-acid staining and PAS staining. All 89 patients were treated by surgery, and most of them received mammary lobule resection, with a mild adjustment based on the patient＇ s condition. The patients were followed up for 1-102 months, median 74 months. The recurrence was reported in one patient. Conclusion The differential diagnosis between GM and breast cancer is difficult and only histopathological examination can confirm a definite diagnosis.
出处
《中华乳腺病杂志（电子版）》
CAS
2013年第3期15-19,共5页
Chinese Journal of Breast Disease(Electronic Edition)
基金
国家自然科学基金重点项目(30930038)
教育部长江学者创新团队发展计划资助项目(IRT0743)
关键词
乳腺炎
肉芽肿
诊断
治疗
mastitis
granuloma
diagnosis
treatment
