Tsuda Banri, Kumaki Nobue, Ishida Rie, Mizuno Mari, Yokoyama Kozue, Oshitanai Risa, Terao Mayako, Morioka Toru, Okamura Takuho, Saito Yuki, Suzuki Yasuhiro, Niikura Naoki
Department of Breast and Endocrine Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
Department of Pathology, Tokai University School of Medicine, Kanagawa, Japan.
Surg Case Rep. 2019 Jul 31;5(1):123. doi: 10.1186/s40792-019-0681-y.
Immunoglobulin (Ig) G4-related sclerosing disease is a pathological concept proposed in Japan during the early 2000s. This lesion-forming disease may exhibit characteristics of a systemic disease but often affects a single organ. To date, IgG4-related sclerosing disease in the mammary gland, or IgG4-related mastitis (IgG4-RM), has rarely been reported.
Here, we describe the case of a female patient who was admitted to our hospital with the main complaints of left breast and axillary lymphadenopathy. A careful diagnostic imaging examination led to an initial suspicion of breast cancer. However, a needle biopsy led to a diagnosis of IgG4-RM. Subsequently, the patient was successfully treated with predonin.
The treatment requirements for breast cancer and IgG4-RM differ considerably. This is a good example of a case wherein unnecessary surgical treatment, which is indicated for breast cancer, was avoided by needle biopsy. Accordingly, the patient was appropriately treated with steroids following a correct diagnosis.
免疫球蛋白（Ig）G4相关硬化性疾病是21世纪初在日本提出的一个病理学概念。这种形成病变的疾病可能表现出系统性疾病的特征，但通常仅累及单一器官。迄今为止，乳腺IgG4相关硬化性疾病，即IgG4相关乳腺炎（IgG4-RM），鲜有报道。
在此，我们描述一名女性患者的病例，该患者因左乳及腋窝淋巴结肿大为主诉入院。细致的诊断性影像学检查最初怀疑为乳腺癌。然而，针吸活检确诊为IgG4-RM。随后，患者接受泼尼松成功治疗。
乳腺癌和IgG4-RM的治疗需求差异很大。这是一个很好的例子，通过针吸活检避免了针对乳腺癌所采用的不必要的手术治疗。因此，患者在正确诊断后接受了适当的类固醇治疗。
