Inoue S, Mogaki M, Kato J, Takazawa T, Natori H, Matsukawa T, Kunitomo K, Fujii H, Sekikawa T, Matsumoto Y
The Department of Surgery, Nirasaki City Hospital, 127-2 Kamo, Kasugai-cho, Higashiyamanashi-gun, Yamanashi 406-0005, Japan.
Breast Cancer. 1998 Jul 25;5(3):313-316. doi: 10.1007/BF02966713.
The benign breast disease sclerosing lymphocytic lobulitis is thought to result from autoimmune diseases causing insulin-dependent diabetes mellitus (IDDM) due to insulinitis. In cases of sclerosing lymphocytic lobulitis accompanied by IDDM, the clinical term gdiabetic fibrous breast disease hhas been proposed. METHODS: A case of sclerosing lymphocytic lobulitis of the breast is described RESULTS: The patient was a 43-year-old woman diagnosed with non insulin-dependent diabetes mellitus (NIDDM) 8 years previously. Insulin therapy was thought to be necessary because treatment with glibenclamide was not effective. She visited our facility complaining of a lump in her right breast that was 5 cm in diameter, painless, rock-hard, discrete, and irregularly outlined. Biopsy was performed because breast cancer was strongly suggested by its hardness and its irregular internal echo on ultrasonography. Histopathological findings demonstrated marked stromal sclerosis and lymphocyte infiltration in the perivascular and perilobular areas. Sclerosing lymphocytic lobulitis was diagnosed. CONCLUSION: Referring physicians should avoid performing unnecessary repeated biopsies by recognizing this disease entity, which often occurs bilaterally.
良性乳腺疾病硬化性淋巴细胞性小叶炎被认为是由自身免疫性疾病导致胰岛素依赖性糖尿病(IDDM),原因是胰岛炎。在伴有IDDM的硬化性淋巴细胞性小叶炎病例中,已提出“糖尿病性纤维性乳腺病”这一临床术语。方法:描述了1例乳腺硬化性淋巴细胞性小叶炎病例。结果:患者为一名43岁女性,8年前被诊断为非胰岛素依赖性糖尿病(NIDDM)。由于格列本脲治疗无效,认为需要胰岛素治疗。她因右乳有一个直径5厘米、无痛、质地坚硬如石、边界清晰且轮廓不规则的肿块前来我院就诊。由于超声检查显示其质地坚硬且内部回声不规则,强烈提示乳腺癌,故进行了活检。组织病理学检查结果显示间质明显硬化,血管周围和小叶周围区域有淋巴细胞浸润。诊断为硬化性淋巴细胞性小叶炎。结论:转诊医生应认识到这种常双侧发生的疾病实体,避免进行不必要的重复活检。