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特发性肉芽肿性乳腺炎:病因、临床表现、诊断与治疗。

Idiopathic Granulomatous Mastitis: Etiology, Clinical Manifestation, Diagnosis and Treatment.

机构信息

Department of Thyroid Breast Surgery, The Affiliated Hospital of Northwest University, Xi'an, Shaanxi Province, China.

出版信息

J Invest Surg. 2022 Mar;35(3):709-720. doi: 10.1080/08941939.2021.1894516. Epub 2021 Mar 10.

Abstract

Idiopathic granulomatous mastitis (IGM) is a rare form of chronic inflammatory breast disease. Although it is a benign breast lesion, it may be sometimes difficult to distinguish from breast cancer. The cause of IGM is unknown, but may be associated with autoimmunity, abnormal hormone levels and infection. While the clinical manifestations of IGM involve various manifestations of inflammation, the diagnosis is principally established by histopathology, characterized by non-caseating granulomas and microabscess formation centered on the breast lobules. Therapeutic options for IGM range from observation to various medical treatments, such as steroids, immunosuppressants, and antibiotics, to surgical intervention, particularly if secondarily infected. Given that the controversy on etiology and treatment choices, we accomplished the present review through reviewing IGM-related literature published in 'Pubmed' and 'Web of science' databases during 1997 to 2020, aiming to provide the basis for rational clinical diagnosis and treatment.

摘要

特发性肉芽肿性乳腺炎(IGM)是一种罕见的慢性炎症性乳腺疾病。虽然它是一种良性乳腺病变,但有时可能难以与乳腺癌区分。IGM 的病因不明,但可能与自身免疫、激素水平异常和感染有关。虽然 IGM 的临床表现涉及各种炎症表现,但诊断主要通过组织病理学确定,其特征是围绕乳腺小叶形成非干酪样肉芽肿和微脓肿。IGM 的治疗选择范围从观察到各种药物治疗,如类固醇、免疫抑制剂和抗生素,到手术干预,特别是如果继发感染。鉴于病因和治疗选择的争议,我们通过回顾 1997 年至 2020 年期间在 'Pubmed' 和 'Web of science' 数据库中发表的与 IGM 相关的文献,完成了本综述,旨在为合理的临床诊断和治疗提供依据。

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