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粗针活检后复发性乳腺炎:叶状肿瘤粗针活检后罕见并发症的病例报告

Recurrent Mastitis after Core Needle Biopsy: Case Report of an Unusual Complication after Core Needle Biopsy of a Phyllodes Tumor.

作者信息

Kasprowicz Nikola, Bauerschmitz Gerd J, Schönherr Alexandra, Baldus Stephan E, Janni Wolfgang, Mohrmann Svjetlana

机构信息

Breast Center, Department of Gynecology and Obstetrics, Düsseldorf University Hospital, Germany.

出版信息

Breast Care (Basel). 2012 Jun;7(3):240-244. doi: 10.1159/000339689. Epub 2012 Jun 22.

Abstract

BACKGROUND

In the routine work-up of suspect breast lesions, ultrasound-controlled core needle biopsy (CNB) is the most common tool to acquire tissue for histopathologic analysis in a safe, quick and convenient way. Complications are generally rare. The most common complications are hematoma and infection, each with less than 1 in 1000 cases. CASE REPORT: Here, we present a case of a 48-year-old patient who underwent CNB for several lesions that were assessed as Breast Imaging Report and Data System (BI-RADS) IV in breast ultrasound and mammography. In the past, she had had 2 bilateral breast reduction surgeries and 1 open biopsy of a fibroadenoma. Histology revealed a phyllodes tumor. Following this, mastitis occurred which was resistant to common conservative measurements such as intravenous antibiotics over months. Finally, mastectomy was performed, followed by adequate wound healing. CONCLUSIONS: In the presented case, the prolonged course of breast infection after CNB was not as expected. If this occurs, conservative treatment with antibiotics can be initiated. Possible additional risk factors such as diabetes mellitus, steroid therapy, or immunosuppression should be identified. However, in case of missing recovery, wide surgical excision is recommended.

摘要

背景

在对可疑乳腺病变的常规检查中,超声引导下的粗针穿刺活检(CNB)是以安全、快速且便捷的方式获取组织进行组织病理学分析的最常用工具。并发症通常很少见。最常见的并发症是血肿和感染,每1000例中发生率均低于1例。病例报告:在此,我们报告一例48岁患者,该患者因乳腺超声和乳腺X线摄影检查中评估为乳腺影像报告和数据系统(BI-RADS)IV类的多个病变接受了CNB。过去,她曾接受过2次双侧乳房缩小手术和1次纤维腺瘤开放活检。组织学检查显示为叶状肿瘤。此后,发生了乳腺炎,数月来对静脉使用抗生素等常见保守治疗方法均无反应。最终,进行了乳房切除术,随后伤口愈合良好。结论:在本病例中,CNB后乳腺感染的病程延长出乎预期。如果发生这种情况,可以开始使用抗生素进行保守治疗。应识别可能的其他风险因素,如糖尿病、类固醇治疗或免疫抑制。然而,如果未能恢复,建议进行广泛的手术切除。

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