浆细胞性乳腺炎术前误诊为乳腺癌、导管内乳头状瘤临床分析  

Clinical Analysis of Plasma Cell Mastitis Misdiagnosed as Breast Cancer and Intraductal Papilloma before Operation

作　　者：曹新河 杨露[2] CAO Xinhe;YANG Lu(The Second Department of Ultrasound,the People's Hospital of Langfang City,Langfang,Hebei 065000,China;Department of Gynaecology,the People's Hospital of Langfang City,Langfang,Hebei 065000,China)

机构地区：[1]廊坊市人民医院超声二科,河北廊坊065000 [2]廊坊市人民医院妇科,河北廊坊065000

出　　处：《临床误诊误治》2023年第7期1-4,共4页Clinical Misdiagnosis & Mistherapy

摘　　要：目的 探讨浆细胞性乳腺炎术前误诊为乳腺癌、导管内乳头状瘤的原因及防范措施。方法 回顾性分析2019年1月—2021年6月收治的术前误诊为乳腺癌、导管内乳头状瘤的浆细胞性乳腺炎14例的临床资料。结果 14例均为非哺乳期女性,均以单侧乳腺内肿块、乳腺局部疼痛为主要症状就诊,伴乳头溢液9例,皮肤局部红肿、皮温升高7例,乳头凹陷5例,乳腺局部压痛5例,可触及同侧腋下淋巴结增大8例。初步诊断为乳腺癌8例、导管内乳头状瘤6例,择期行乳腺病灶切除术治疗,术中快速冷冻病理检查示浆细胞性乳腺炎。误诊时间5~7 d。遂10例改行乳腺区段切除术,4例改行乳管切除术,术后均一期愈合出院,术后随访2年,无复发。结论 浆细胞性乳腺炎临床发病率低,早期表现常不典型,未行病理学检查前极易误诊。加强临床医生对本病的认识,提高警惕性,必要时及早行细针穿刺活检,以提高本病术前确诊率。Objective To investigate the causes and preventive measures of plasma cell mastitis misdiagnosed as breast cancer and intraductal papilloma before operation.Methods The clinical data of 14 patients with plasma cell mastitis who were misdiagnosed as breast cancer and intraductal papilloma before surgery and admitted to our hospital from January 2019 to June 2021 were retrospectively analyzed.Results All of the 14 cases were non-lactating females,and the main symptoms were unilateral mammary mass and local mammary pain.There were 9 cases with nipple discharge,7 cases with local skin redness and swelling and skin temperature rise,5 cases with nipple depression,5 cases with local mammary tenderness,and 8 cases with enlargement of palpable ipsilateral axillary lymph nodes.The initial diagnosis was breast cancer in 8 cases and intraductal papilloma in 6 cases.Elective resection of breast lesions was performed.Rapid frozen pathologic examination during operation revealed plasma cell mastitis.The misdiagnosis lasted 5-7 d.Then,10 cases underwent breast segmentectomy and 4 cases underwent breast duct resection.All patients were discharged from the hospital after healing by first intention.No recurrence was observed after 2 years of follow-up.Conclusion The clinical incidence of plasma cell mastitis is low,the early manifestations are often atypical,and it is more likely to cause misdiagnosis before pathological examination.Strengthening the clinician's understanding of this disease,enhancing the vigilance,and performing fine needle puncture biopsy as soon as necessary are needed to improve the preoperative diagnosis rate of this disease.

关 键 词：浆细胞性乳腺炎 误诊 乳腺肿瘤 导管内乳头状瘤 超声检查 乳头溢液 浆细胞浸润 活组织检查 针吸 

分 类 号：R655.8[医药卫生—外科学]