From the Departments of Radiodiagnosis (S.V., K.R., A.D., S.H.), Surgery (A.S.), and Pathology (S.M.), All India Institute of Medical Sciences, New Ansari Nagar, New Delhi 110029, India.
Radiology. 2020 Nov;297(2):487-491. doi: 10.1148/radiol.2020190501.
History A 44-year-old woman who was a resident of Bihar, which is a state in eastern India, presented to the surgical outpatient department of our hospital with a history of gradually increasing swelling of the right breast associated with redness, pain, and itching over the past month. She reported a general sense of malaise and experienced episodes of chills over the past 6 months; however, she had no documented fever. There was no history of breast trauma. No history suggestive of a possible hypercoagulable state could be elicited (she was a nonsmoker, had undergone uncomplicated normal vaginal delivery 15 years earlier, was not taking oral contraceptives, and had no history to suggest past deep venous thrombosis). General physical examination findings were unremarkable. On local examination, she was found to have diffuse enlargement of the right breast. The skin over the lateral part of the breast was erythematous and showed the presence of prominent superficial veins. On palpation, few ill-defined firm mobile masses were found in the upper outer quadrant with overlying skin induration. No skin ulceration or nipple discharge was present. Few firm and discrete lymph nodes were palpable in the right axilla. Laboratory investigations showed mild anemia (hemoglobin level, 10 g/dL; normal range, 12-15 g/dL), a total leukocyte count of 14 000 cells per microliter (14 cells × 10/L) (normal range, 4500-11 000 cells per microliter [4.5-11 cells × 10/L]), a normal differential leukocyte count (74% neutrophils [normal range, 40%-80%], 24% lymphocytes [normal range, 20%-40%], and 2% eosinophils [normal range, 1%-4%]), and an erythrocyte sedimentation rate of 31 mm per hour (normal range, 0-29 mm per hour). She underwent both mammography and US. Real-time US showed mobile structures on the series of US images obtained seconds apart. On the basis of the imaging findings, US-guided fine-needle aspiration cytology was performed to confirm the diagnosis, and appropriate treatment was instituted.
病史 一名 44 岁女性，来自印度东部比哈尔邦，因右乳房逐渐肿大伴红肿、疼痛和瘙痒来我院外科门诊就诊。她自述过去一个月一直感到不适，并出现寒战发作，但无发热记录。无明确的易栓状态病史（不吸烟，15 年前经阴道分娩，未服用口服避孕药，也无深静脉血栓形成病史）。一般体格检查未见异常。局部检查发现右乳房弥漫性肿大。乳房外侧皮肤呈红斑状，可见明显的浅表静脉。触诊时，上外象限可触及几个界限不清的坚硬可移动肿块，伴有皮肤硬结。无皮肤溃疡或乳头溢液。右侧腋窝可触及几个坚硬、离散的淋巴结。实验室检查显示轻度贫血（血红蛋白 10 g/dL；正常范围 12-15 g/dL），白细胞总数为 14 000 个/微升（14 细胞×10/L）（正常范围 4500-11 000 个/微升[4.5-11 细胞×10/L]），白细胞分类正常（74%中性粒细胞[正常范围 40%-80%]，24%淋巴细胞[正常范围 20%-40%]，2%嗜酸性粒细胞[正常范围 1%-4%]），红细胞沉降率为 31 mm/小时（正常范围 0-29 mm/小时）。她接受了乳房 X 线摄影和超声检查。实时超声显示在获得的一系列超声图像中，有移动的结构。基于影像学结果，进行了超声引导下细针抽吸细胞学检查以明确诊断，并进行了适当的治疗。
