Shaffrey Julie K., Askin Frederic B., Gatewood Olga M. B., Brem Rachel
The Breast Imaging Center and Interventional Center, The Russell H. Morgan Department of Radiology and Radiologic Science and the Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, and The Breast Imaging and Interventional Center, The George Washington University Medical Center, Washington, DC.
Breast J. 2000 Nov;6(6):414-417. doi: 10.1046/j.1524-4741.2000.99068.x.
Diabetic fibrous mastopathy, an unusual finding in patients with early onset, long-standing insulin dependent diabetes, can present as a palpable mass with mammographic and sonographic findings highly suggestive of breast cancer. These suspicious clinical and imaging findings necessitate a biopsy, which demonstrates characteristic findings of dense, keloid scarring and intralobular lymphocytic infiltrates. We present 2 cases of diabetic fibrous mastopathy with characteristic mammographic, sonographic, and pathologic findings diagnosed with ultrasound guided core needle biopsy and confirmed with surgical excision. In the appropriate clinical setting, a patient with long-standing insulin dependent diabetes with a firm, mobile breast mass and characteristic sonographic findings of a hypoechoic mass with lobulation and marked posterior acoustic shadowing should suggest the possibility of diabetic fibrous mastopathy. Awareness of this entity may obviate the need for surgical excision in patients whose clinical, imaging, and pathologic findings are consistent with diabetic fibrous mastopathy.
糖尿病性纤维性乳腺病是早发、长期胰岛素依赖型糖尿病患者中一种不常见的表现，可表现为可触及的肿块，乳房X线摄影和超声检查结果高度提示乳腺癌。这些可疑的临床和影像学表现需要进行活检，活检显示出致密、瘢痕疙瘩样瘢痕形成和小叶内淋巴细胞浸润的特征性表现。我们报告2例糖尿病性纤维性乳腺病，具有特征性的乳房X线摄影、超声和病理表现，通过超声引导下粗针穿刺活检诊断，并经手术切除证实。在适当的临床情况下，长期胰岛素依赖型糖尿病患者出现质地硬、可活动的乳腺肿块，以及超声检查显示低回声肿块、有分叶和明显后方声影的特征性表现，应提示糖尿病性纤维性乳腺病的可能性。认识到这一实体情况，对于临床、影像学和病理表现与糖尿病性纤维性乳腺病一致的患者，可能无需进行手术切除。
