Ruiter Annabel M, Vegting Irene L, Nanayakkara Prabath W B
Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.
BMJ Case Rep. 2010 Nov 18;2010:bcr0320102844. doi: 10.1136/bcr.03.2010.2844.
The patient in this case was seen by numerous doctors for a long time before the diagnosis was made because, right from the start, an abscess or a cancer of the breast was suspected. She was first seen by her general practitioner (GP); thereafter, she went to two consultant physicians and a surgeon in a regional hospital and eventually an idiopathic granulomatous mastitis (IGM) diagnosis was made by a specialist in internal medicine in a university hospital. When the diagnosis IGM was made, the patient was treated with steroids and made a complete recovery. Although the incidence of IGM is not high, the GPs are likely to see these patients initially and should be aware of the existence of this disease, which may spare the patient unnecessary consultations, diagnostics tests or even mastectomy.
在确诊之前,该病例的患者被多位医生诊治了很长时间,因为从一开始就怀疑是乳房脓肿或癌症。她首先去看了全科医生(GP);此后,她又去了一家地区医院的两位会诊医生和一位外科医生处,最终在一家大学医院,一位内科专家做出了特发性肉芽肿性乳腺炎(IGM)的诊断。确诊IGM后,患者接受了类固醇治疗并完全康复。虽然IGM的发病率不高,但全科医生很可能首先接诊这些患者,应该了解这种疾病的存在,这可以避免患者进行不必要的会诊、诊断检查甚至乳房切除术。