Department of Surgery, PGIMER, Dr Ram Manohar Lohia Hospital, New Delhi, India.
Department of Minimal Invasive, GI and Bariatric Surgery, Metro Heart Institute with Multispeciality, Faridabad, India
BMJ Case Rep. 2020 Aug 31;13(8):e234979. doi: 10.1136/bcr-2020-234979.
A 35-year-old woman presented to the surgery outpatient department with a lump in her right breast for 2 months and pain for 1 month. After clinical examination and relevant investigations, we kept a working diagnosis of antibioma. The lump was excised under local anaesthesia and biopsy was sent. However, histopathological examination reported multiple non-caseating granulomas without acid-fast bacilli. Two months later, she developed a sinus with serous discharge at the scar site. At the same time, she developed pain in the left upper breast, which subsequently progressed to an abscess. Incision and drainage of the abscess was done, but the wound did not heal, and a discharging sinus appeared at the site. Finally, a diagnosis of idiopathic granulomatous mastitis was made, after excluding all other causes, and the patient was prescribed oral steroids. She recovered fully after 8 months and there is no recurrence till date.
一位 35 岁女性因右乳肿块 2 个月，伴疼痛 1 个月就诊于外科门诊。经过临床检查和相关检查，我们初步诊断为乳腺脓肿。肿块在局部麻醉下切除，并进行了活检。然而，组织病理学检查报告显示有多发性非干酪样肉芽肿，无抗酸杆菌。两个月后，她在疤痕处出现窦道，有浆液性分泌物。同时，她左乳上部出现疼痛，随后发展为脓肿。切开引流脓肿后，伤口未愈合，在该部位出现窦道。最终，在排除其他所有原因后，诊断为特发性肉芽肿性乳腺炎，给予口服类固醇治疗。患者 8 个月后完全康复，至今无复发。
