肉芽肿性小叶性乳腺炎误诊临床分析
Clinical Analysis of Misdiagnosis of Granulomatous Lobular Mastitis
周海洋 1李浩 1王石林 1魏学明 1王妍 1郑子阳 1张玉辉1
作者信息
- 1. 100036 北京,空军特色医学中心普通外科
- 折叠
摘要
目的 探讨肉芽肿性小叶性乳腺炎的临床特点、误诊原因和防范措施.方法 回顾性分析 2018 年 1月—2023 年12 月收治的曾误诊的18 例肉芽肿性小叶性乳腺炎的临床资料.结果 本组16 例以乳腺肿块就诊,2 例以皮肤破溃流脓就诊;13 例误诊为炎性乳腺癌,5 例误诊为乳腺结核.误诊时间 7～22(9.31±1.36)d.误诊为炎性乳腺癌患者手术切除病灶进行病理学检查,确诊为肉芽肿性小叶性乳腺炎.误诊为乳腺结核患者抗结核治疗后反复发作,行手术治疗,分泌物行细菌培养及病原学检查均为阴性,病理学检查确诊为肉芽肿性小叶性乳腺炎.所有患者进行外科手术治疗,将乳腺病灶完整切除,切除后行抗感染治疗7d,14 例术后口服醋酸泼尼松30 d,其余4 例未使用口服药物.本组18 例均治愈.结论 肉芽肿性小叶性乳腺炎较为罕见且无典型临床表现,容易与乳腺癌、结核性乳腺炎等疾病混淆,发生误诊.临床医生需加强对肉芽肿性小叶性乳腺炎的疾病知识学习,提高对其警惕性,综合分析病情,认真鉴别诊断,以减少肉芽肿性小叶性乳腺炎误诊的发生.
Abstract
Objective To investigate the clinical features,causes of misdiagnosis and preventive measures of granu-lomatous lobular mastitis(GLM).Methods The clinical data of 18 misdiagnosed patients with GLM treated from January 2018 to December 2023 were retrospectively analyzed.Results In this group,16 patients presented with breast mass,and 2 patients presented with skin ulceration and pus.Thirteen patients were misdiagnosed as inflammatory breast cancer and 5 pa-tients were misdiagnosed as breast tuberculosis.The duration of misdiagnosis was 7-22(9.31±1.36)d.The patient misdiag-nosed with inflammatory breast cancer was diagnosed with GLM after surgical resection and pathological examination.The pa-tient misdiagnosed with breast tuberculosis had recurrence after anti-tuberculosis treatment,and underwent surgical resection.The secretions were tested by bacterial culture and pathogen testing,all of which were negative.The pathological examination confirmed the diagnosis as GLM.All patients underwent surgical treatment,the breast lesions were completely removed,and anti-infective treatment was given for 7 d after resection.Of them,14 patients took oral prednisone acetate for 30 d after sur-gery,and the other 4 patients did not take oral drugs.All the 18 patients were cured.Conclusion GLM is rare and has no typical clinical manifestations.It is more likely to be confused with breast cancer and tuberculous mastitis and misdiagnosed.It is necessary for clinicians to strengthen the knowledge of GLM,enhance the vigilance of the disease,comprehensively ana-lyze the condition,and perform the differential diagnosis carefully,so as to reduce the misdiagnosis of GLM.
关键词
肉芽肿性小叶性乳腺炎/误诊/炎性乳腺癌/乳腺结核/病理学/磁共振成像/诊断/鉴别诊断Key words
Granulomatous lobular mastitis/Misdiagnosis/Inflammatory breast cancer/Breast tuberculosis/Pathol-ogy/Magnetic resonance imaging/Diagnosis/Differential diagnosis引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据