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中华普通外科学文献(电子版) ›› 2010, Vol. 04 ›› Issue (06) : 527 -530. doi: 10.3877/cma.j.issn.1674-0793.2010.06.006

所属专题: 文献

论著

非哺乳期乳腺外周慢性炎症的临床特点
李玺1,(), 刘仁斌1, 邱万寿1, 黄勇1, 姜华1, 刘瑞磊1, 吴珏堃1, 黄泽楠1   
  1. 1. 510630 广州,中山大学附属第三医院甲状腺乳腺外科
  • 收稿日期:2010-03-22 出版日期:2010-12-01
  • 通信作者: 李玺

Clinical features of peripheral nonlactational chronic mastitis

Xi LI1,(), Ren-bin LIU1, Wan-shou QIU1, Yong HUANG1, Hua JIANG1, Rui-lei LIU1, Yu-kun WU1, Ze-nan HUANG1   

  1. 1. Thyroid and Breast Surgery Department, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2010-03-22 Published:2010-12-01
  • Corresponding author: Xi LI
  • About author:
    Corresponding author: LI Xi, Email:
引用本文:

李玺, 刘仁斌, 邱万寿, 黄勇, 姜华, 刘瑞磊, 吴珏堃, 黄泽楠. 非哺乳期乳腺外周慢性炎症的临床特点[J/OL]. 中华普通外科学文献(电子版), 2010, 04(06): 527-530.

Xi LI, Ren-bin LIU, Wan-shou QIU, Yong HUANG, Hua JIANG, Rui-lei LIU, Yu-kun WU, Ze-nan HUANG. Clinical features of peripheral nonlactational chronic mastitis[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(06): 527-530.

目的

总结分析非哺乳期乳腺外周慢性炎症的临床特点,提高对该病的诊治水平。

方法

回顾性分析2006年1月至2009年12月期间收治的35例非哺乳期乳腺外周慢性炎症患者的临床资料。

结果

35例患者无明显发热和局部乳房红肿表现,术前15例诊断为乳腺癌,20例乳腺癌未排除,伴乳房疼痛20例,合并免疫功能下降13例。17例既往有哺乳期乳腺炎病史,与其他患者相比,此组患者年龄较轻,多伴有疼痛症状,较少合并免疫功能低下。14例行空芯针穿刺,12例确定为慢性炎症。27例患者行手术治疗,病理诊断为乳腺慢性炎症、乳腺组织坏死并慢性炎症、肉芽肿性乳腺炎和浆细胞性乳腺炎。手术方法包括病灶完整切除,创面开放引流或置管冲洗,患者均痊愈。

结论

外周非哺乳期乳腺慢性炎症易与乳腺癌混淆,空芯针穿刺活检是确诊本病的有效手段。与传统术式比较,对有感染灶残留的病灶切除后置管冲洗引流可缩短病程。

Objective

To summarize the clinical features of peripheral nonlactational chronic mastitis and improve the diagnosis and treatment.

Methods

Retrospectively analysis of clinicopathological data of 35 patients diagnosed as peripheral nonlactational chronic mastitis in the past four years.

Results

At admission 15 patients were diagnosed as breast cancer and 20 patients could not be ruled out the diagnosis of breast cancer. All patients had no fever and local reddening and swelling. There were 20 cases with breast pain and 13 cases with immunodeficiency. Patients with lactational mastitis history were younger, had higher incidence of breast pain, and lower incidence of immunodeficiency than those without. Core biopsy was done in 14 patients and 12 chronic mastitis were diagnosed. Twenty-seven patients underwent surgical treatment. Pathological diagnosis included chronic mastitis, necrotic lesion with chronic inflammation, granulomatous mastitis and plasma cell mastitis. Core biopsy was performed on 14 patients and 12 were chronic inflammation. Surgical treatments including completely resection, open drainage or tube drainage. All patients were cured after treatment.

Conclusions

Misdiagnosis of peripheral nonlactational chronic mastitis as breast cancer is common. Core biopsy is effective for pathological diagnosis. Chronic mastits is easy to relapse and surgical treatment is necessary. Compared with open drainage, the method of lumpectomy combined with irrigation and instillation of antibiotics can shorten course of disease.

表1 有无急性乳腺炎病史两组患者的临床表现(例)
1
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2
Vaidyanathan L,Barnard K,Elnicki DM. Benign breast disease: when to treat, when to reassure, when to refer. Cleve Clin J Med, 2002, 69(5): 425-432.
3
Lester SC. Differential diagnosis of granulomatous mastitis. Breast J, 2005, 11(6): 534-535.
4
Bani-Hani KE,Yaghan RJ,Matalka II, et al. Idiopathic granulomatous mastitis: time to avoid unnecessary mastectomies. Breast J, 2004, 10(4): 318-322.
5
戴文海,徐军红,尹本德. 成簇样钙化对乳腺癌的诊断价值. 实用诊断与治疗杂志, 2006, 20(9): 654-655.
6
高友福,陈宏. 乳腺良恶性病变的钼靶X线征象与病理特征. 实用诊断与治疗杂志, 2006, 20(6): 424-425.
7
Fondfinier E,Lorimier G,Guerin Boblet V. Breast microcalifications: multivariate analysis of radiologic and clinical factors for carcinoma. Word J Surg, 2002, 26(3): 290-296.
8
Prasad SN,Houserkova D. A comparison of mammography and ultrasonography in the evaluation of breast masses. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007, 151(2): 315-322.
9
金桂龙,丁之玮,郭玉霞, 等. 彩色多普勒超声显像对非哺乳期乳腺炎的诊断价值.浙江临床医学, 2008, 10(1): 130.
10
Leborgne F. Treatment of breast abscesses with sonographically guided aspiration, irrigation, and instillation of antibiotics. AJR Am J Roentgenol, 2003, 181(4):1089-1091.
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