Yajima S, Fukutomi T, Akashi-Tanaka S, Nanasawa T, Miyakawa K, Hasegawa T
Department of Surgical Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Breast Cancer. 2001;8(3):246-9. doi: 10.1007/BF02967517.
We report a case of insulin-dependent diabetic fibrous mastopathy with special reference to the findings of computed tomography (CT). The patient was a 27-year-old woman with a history of insulin-dependent diabetes mellitus from childhood who presented with a right breast tumor. Physical examination showed a stony-hard, ill-defined but freely movable mass under the nipple of the right breast without nipple discharge. Mammography revealed a high-density mass shadow without microcalcifications or spicular formation. Ultrasonographic examination revealed an irregularly-shaped hypoechoic lesion with marked posterior acoustical shadowing. Contrast-enhanced CT revealed poor early phase contrast enhancement and slight delayed phase heterogeneous enhancement. Since core needle biopsy revealed fibrocystic disease, the lesion was suspicious for diabetic mastopathy. Incisional biopsy of the right breast lump was performed. On histopathological examination, the lesion showed fibrosis with dense lymphocytic infiltration around the lobules. Diabetic fibrous mastopathy was diagnosed. Physicians should be aware of the association of long-standing diabetes mellitus with the development of fibrous mastopathy. CT is considered a useful tool to differentiate diabetic mastopathy from breast cancer.
我们报告一例胰岛素依赖型糖尿病性纤维性乳腺病，并特别提及计算机断层扫描（CT）的检查结果。患者为一名27岁女性，自幼患有胰岛素依赖型糖尿病，因右乳肿物就诊。体格检查发现右乳乳头下有一质地坚硬、边界不清但可自由活动的肿块，无乳头溢液。乳腺钼靶检查显示高密度肿块影，无微钙化或毛刺状形成。超声检查发现一个形状不规则的低回声病变，伴有明显的后方声影。增强CT显示早期强化不佳，延迟期有轻微的不均匀强化。由于粗针活检显示为纤维囊性疾病，该病变怀疑为糖尿病性乳腺病。遂对右乳肿块进行了切开活检。组织病理学检查显示病变为纤维化，小叶周围有密集的淋巴细胞浸润。诊断为糖尿病性纤维性乳腺病。医生应意识到长期糖尿病与纤维性乳腺病发生之间的关联。CT被认为是鉴别糖尿病性乳腺病与乳腺癌的有用工具。
