Konstantinopoulos Panagiotis A, Dezube Bruce J, March David, Pantanowitz Liron
Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Breast J. 2007 Mar-Apr;13(2):192-5. doi: 10.1111/j.1524-4741.2007.00401.x.
The differential diagnosis of a breast mass in an HIV-infected patient is broad. We report a case of HIV-associated intramammary lymphadenopathy that manifested itself as a painful solitary breast mass best demonstrated by ultrasound imaging. Fine-needle aspiration (FNA), ultrasound-guided core needle biopsy, and subsequent excisional biopsy demonstrated an intramammary lymph node with reactive changes typical of acute HIV-associated lymphadenopathy. Intramammary lymphadenopathy, an otherwise under-reported entity, should be included in the differential diagnosis of a breast mass in an HIV-positive patient. FNA sampling alone can be adequate in such low suspicion breast lesions that appear benign on clinical and imaging evaluations, provided that sufficient cellular material is procured for ancillary studies to exclude infection and malignancy.
HIV感染患者乳腺肿块的鉴别诊断范围很广。我们报告一例HIV相关的乳腺内淋巴结病,表现为疼痛性孤立性乳腺肿块,超声成像最能清晰显示。细针穿刺抽吸(FNA)、超声引导下粗针活检及随后的切除活检显示为乳腺内淋巴结,伴有急性HIV相关淋巴结病典型的反应性改变。乳腺内淋巴结病这一通常报道较少的实体,应纳入HIV阳性患者乳腺肿块的鉴别诊断中。对于临床和影像学评估显示为良性、怀疑程度较低的乳腺病变,仅FNA采样可能就足够了,前提是获取足够的细胞材料用于辅助研究以排除感染和恶性肿瘤。