囊性中性粒细胞性肉芽肿性乳腺炎的临床病理特征分析  

Clinicopathological features of cystic neutrophilic granulomatous mastitis

作　　者：王立娟[1] 曾敏[1] 王成龙 王亚东 刘曦 曹晓静 邹凌凤[1] 谈宗明 Wang Lijuan;Zeng Min;Wang Chenglong;Wang Yadong;Liu Xi;Cao Xiaojing;Zou Lingfeng;Tan Zongming(Department of Pathology,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China;Department of Breast and Tyroid Surgery,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China;Department of Radiology,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400021,China;Department of Pathology,Chongqing Liangping District Hospital of Traditional Chinese Medicine,Chongqing 405200,China)

机构地区：[1]重庆市中医院病理科,重庆400021 [2]重庆市中医院乳甲外科,重庆400021 [3]重庆市中医院放射科,重庆400021 [4]重庆市梁平区中医院病理科,重庆405200

出　　处：《中华普通外科杂志》2023年第5期352-356,共5页Chinese Journal of General Surgery

摘　　要：目的探讨囊性中性粒细胞性肉芽肿性乳腺炎的病因及临床病理特征。方法回顾性分析2019年1月1日至2020年12月31日重庆市中医院和重庆市梁平区中医院经穿刺组织病理诊断为囊性中性粒细胞性肉芽肿性乳腺炎95例患者的临床病理资料。结果本组95例女性患者中位发病年龄为32(21~50)岁。24例血清泌乳素升高,53例血清类风湿抗体谱一项或多项指标升高,26例血清甲状腺抗体一项或两项指标升高,14例血清抗中性粒细胞抗体谱一项或多项指标升高,33例红细胞沉降率升高,36例血清C反应蛋白升高。革兰染色显示杆菌阳性有78例。组织学形态:以乳腺小叶为中心的化脓性肉芽肿,肉芽肿中心为囊性空泡。免疫组织化学检查显示肉芽肿内及周围的炎症细胞主要以CD3+的T细胞为主,CD4+的T细胞数量多于CD8+的T细胞。结论囊性中性粒细胞性肉芽肿性乳腺炎属于特发性肉芽肿性乳腺炎的少见类型,诊断依赖于其特殊的病理表现。Objective To investigate the etiology,clinical manifestations,clinicopathological features of cystic neutrophil granulomatous mastitis(CNGM).Methods From Jan 2019 to Dec 2020,95 CNGM cases diagnosed by biopsy pathology at Chongqing Hospital of Traditional Chinese Medicine and Chongqing Liangping District Hospitol of Traditional Chinese Medicine were reviewed.Results There were 95 female patients,aged 21 to 50 years,with a median age of 32 years.Laboratory examination showed that 56%(53/95)cases had elevated rheumatoid antibody level,27%(26/95)had increased level of serum thyroid antibody,15%(14/95)had elevated antineutrophil antibody,35%(33/95)had increased ESR,38%(36/95)had increased C-reactive protein.The positive rate of Gram-stained bacilli was 82%(78/95).Histology:pyogenic granuloma with lobule of breast as the center,the center of granuloma was cystic vacuole.Immunohistochemistry showed that the inflammatory cells in and around granuloma were mainly CD3+cells,and CD4+cells were more than CD8+cells.Conclusions The cystic neutrophilie granulo matous mastitis is a rare type of idiopathic granulomatous mastitis.The diagnosis of CNGM is dependent on its specific pathological features.

关 键 词：肉芽肿性乳腺炎 病理学 临床 革兰氏阳性杆菌 

分 类 号：R655.8[医药卫生—外科学]