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乳腺结核:一种古老疾病的罕见表现。

Tuberculosis of the breast: an uncommon presentation of an old disease.

作者信息

Galego Maria Antonia, Lage Gisela, Shekhovtsova Maria, Duarte Raquel

机构信息

Pulmonology Department, Unidade Local de Saúde de Matosinhos E.P.E., Matosinhos, Portugal.

Anatomical Pathology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho E.P.E., Vila Nova de Gaia, Portugal.

出版信息

BMJ Case Rep. 2019 Feb 22;12(2):e227014. doi: 10.1136/bcr-2018-227014.

Abstract

Breast tuberculosis (TB) is considered an uncommon disease with an estimated incidence of 0.1% of all breast lesions reported in developed countries. A 53-year-old Caucasian woman, with a medical history of Crohn's disease, previously treated with infliximab for 3 months suspended due to a presumptive diagnosis of TB for which antitubercular regimen was started. Five months after, a painful lump in the left breast was identified by the patient. Mammary ultrasound confirmed left breast nodules and axillary adenopathies. Histology and microbiology of both lesions confirmed breast TB. Molecular drug susceptibility testing in both samples revealed no resistance to first line anti-TB drugs and the regimen was maintained for 1 year, with clinical and radiological improvement. Mammary gland involvement usually results from lymphatic extension and differential diagnosis frequently includes breast cancer or bacterial abscess.

摘要

乳腺结核被认为是一种罕见疾病,在发达国家,其发病率估计占所有乳腺病变报告的0.1%。一名53岁的白种女性,有克罗恩病病史,曾因疑似结核病接受英夫利昔单抗治疗3个月,后因启动抗结核治疗方案而暂停。五个月后,患者发现左乳有一个疼痛性肿块。乳腺超声证实左乳结节和腋窝淋巴结肿大。两个病变的组织学和微生物学检查均确诊为乳腺结核。两个样本的分子药敏试验显示对一线抗结核药物无耐药性,该治疗方案维持了1年,临床和影像学均有改善。乳腺受累通常由淋巴蔓延引起,鉴别诊断常包括乳腺癌或细菌性脓肿。

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