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乳房结核:一家机构 10 年的经验。

Tuberculosis of the breast: 10 years' experience in one institution.

机构信息

Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University, Kaohsiung, Taiwan.

出版信息

Int J Tuberc Lung Dis. 2010 Jun;14(6):758-63.

Abstract

SETTING

Breast tuberculosis (TB) is rare even in endemic areas. Its presentation is variable and non-specific, and its diagnosis is therefore usually delayed.

DESIGN

We recruited breast TB cases between 1998 and June 2009 at Kaohsiung Medical Center in southern Taiwan. We retrospectively reviewed the clinical features, diagnosis and management of breast TB.

RESULTS

A total of 26 patients with breast TB (25 females) were included in this study. The most common presentation was breast tumour, followed by breast abscess and painful sensation. Patients received partial mastectomy or incision and drainage. The pathological examination revealed granulomatous inflammation, acute and chronic inflammation or both. Polymerase chain reaction has very low sensitivity in diagnosing breast TB. The interval between initial presentation and definite treatment was an average of 54.5 days. All patients received anti-tuberculosis chemotherapy, with excellent response.

CONCLUSION

The presentation of breast TB is variable and diagnosis is usually delayed. The disease can be diagnosed through pathological tests and a high suspicion by experienced physicians. The definite treatment is adequate anti-tuberculosis chemotherapy after surgical excision or drainage.

摘要

背景

即使在结核病高发地区,乳房结核(TB)也很少见。其临床表现多种多样且不具特异性,因此通常会延误诊断。

设计

我们于 1998 年至 2009 年 6 月在台湾南部高雄医学中心招募乳房 TB 病例。我们回顾性分析了乳房 TB 的临床特征、诊断和治疗。

结果

本研究共纳入 26 例乳房 TB 患者(25 名女性)。最常见的表现是乳房肿瘤,其次是乳房脓肿和疼痛。患者接受了部分乳房切除术或切开引流术。病理检查显示肉芽肿性炎症、急性和慢性炎症或两者兼有。聚合酶链反应在诊断乳房 TB 方面的敏感性非常低。从初次就诊到明确治疗的平均间隔时间为 54.5 天。所有患者均接受抗结核化疗,反应良好。

结论

乳房 TB 的表现多种多样,诊断通常会被延误。可以通过病理检查和经验丰富的医生的高度怀疑来确诊。在手术切除或引流后,明确的治疗方法是充分的抗结核化疗。

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