Kobayashi Kanako, Yano Shuichi, Ikeda Toshikazu, Kadowaki Toru, Wakabayashi Kiryo, Kimura Masahiro, Ishikawa Shigenori, Takeyama Hiroyasu
Department of Pulmonary Medicine, National Hospital Organization Matsue National Hospital, 5-8-31, Agenogi, Matsue-shi, Shimane 690-8556 Japan.
Kekkaku. 2009 Jul;84(7):541-4.
A 80-year-old woman was admitted to our hospital because of left axillary swelling. Needle biopsy specimen showed negative results on a smear for acid-fast bacilli and PCR. The histological findings showed epithelioid cell granuloma with caseous necrosis. QFT TB-2G showed positivity of 1.9 IU/ml in ESAT-6. We diagnosed tuberculous lymphadenopathy and administered antituberculous drugs. After 3 weeks of treatment, in spite of the regression of lymphadenopathy, mammary swelling had progressed. We performed a biopsy of the mammary lesion, but did not detect any abnormal findings. As the mammary lesion had regressed by the continued treatment of antituberculous drugs, we thought the mammary swelling was paradoxical worsening.
一名80岁女性因左腋窝肿胀入住我院。针吸活检标本涂片抗酸杆菌及聚合酶链反应结果均为阴性。组织学检查发现上皮样细胞肉芽肿伴干酪样坏死。QFT TB-2G检测显示ESAT-6为1.9 IU/ml呈阳性。我们诊断为结核性淋巴结病并给予抗结核药物治疗。治疗3周后，尽管淋巴结病有所消退，但乳腺肿胀却有所进展。我们对乳腺病变进行了活检，但未发现任何异常。由于继续抗结核药物治疗后乳腺病变有所消退，我们认为乳腺肿胀是反常恶化。
