Tan Ee Syn, Friesen Brendon, Loh Seow Foong, Fox Jane
Department of General Surgery (Monash Health), 135-145 David Street, Dandenong, VIC 3175, Australia.
Lake Imaging, St John of God Hospital, Geelong, VIC, Australia.
Int J Surg Case Rep. 2017;37:169-172. doi: 10.1016/j.ijscr.2017.06.012. Epub 2017 Jun 15.
IgG4-related mastitis (IgG4-RM) is exceedingly rare with only ten cases reported in the literature to date. Organs that are affected with IgG4-related disease (IgG4-RD) all share the same histopathological hallmarks consisting of dense lymphocytic infiltration, storiform fibrosis and obliterative phlebitis.
This case report highlights a case of IgG4-RM found incidentally in a 52-year-old woman during a routine breast screen and it explores the current literature about IgG4-RM and IgG4-RD.
IgG4-RM and IgG4-RD, in general, is a new entity in the field of medicine and its aetiology is not well understood. In the literature, IgG4-RM often presents as a painless palpable breast lump in isolation or with other systemic manifestations. IgG4-RM is considered benign and has excellent prognosis post-conservative treatment with steroid or surgical excision.
IgG4-RM is diagnosed exclusively on histological analysis. It is hard to distinguish IgG4-RD from malignant breast lesions purely on clinical examination and imaging studies. Increasing awareness of this condition among clinicians will assist them in managing patients better. Extensive whole body imaging is not recommended unless symptomatic.
IgG4相关性乳腺炎（IgG4-RM）极为罕见，迄今为止文献中仅报道了10例。受IgG4相关性疾病（IgG4-RD）影响的器官都具有相同的组织病理学特征，包括密集的淋巴细胞浸润、束状纤维化和闭塞性静脉炎。
本病例报告重点介绍了一名52岁女性在常规乳房筛查中偶然发现的IgG4-RM病例，并探讨了目前关于IgG4-RM和IgG4-RD的文献。
一般而言，IgG4-RM和IgG4-RD是医学领域中的一种新疾病实体，其病因尚不完全清楚。在文献中，IgG4-RM通常表现为孤立的无痛性可触及乳房肿块或伴有其他全身表现。IgG4-RM被认为是良性的，经类固醇保守治疗或手术切除后预后良好。
IgG4-RM仅通过组织学分析诊断。仅通过临床检查和影像学研究很难将IgG4-RD与恶性乳腺病变区分开来。临床医生对这种疾病的认识提高将有助于他们更好地管理患者。除非有症状，否则不建议进行广泛的全身成像检查。
