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肉芽肿性乳腺炎:一种折磨少数族裔女性的诊断不足的炎症性疾病。

Granulomatous mastitis: An underdiagnosed inflammatory disease afflicting minority women.

作者信息

Bacon Daniel R, Ngeve Smith M, Jordan Sheryl G

机构信息

University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.

出版信息

Radiol Case Rep. 2021 Oct 22;16(12):3990-3994. doi: 10.1016/j.radcr.2021.09.044. eCollection 2021 Dec.

Abstract

Granulomatous mastitis (GM) is an underdiagnosed and understudied benign inflammatory disease of the breast whose accurate diagnosis is confounded by mimicry of other breast pathologies (infectious mastitis and abscess, malignancy) and limited clinician knowledge of the disease. GM disproportionately affects minority women, furthering health disparities for a demographic already disadvantaged in the care of breast diseases. The first step in diagnosis is ultrasound followed by core needle biopsy yielding granulomatous inflammation. To far lesser degree, mammography, and MRI may play a role in narrowing the differential. A high index of clinical suspicion and multidisciplinary approach is required. The presence of Corynebacterium kroppensteddti may indicate one subtype of granulomatous mastitis called cystic neutrophilic granulomatous mastitis; disease stratification, and individualized therapy are on the horizon.

摘要

肉芽肿性乳腺炎(GM)是一种诊断不足且研究较少的乳腺良性炎症性疾病,其准确诊断因其他乳腺病变(感染性乳腺炎和脓肿、恶性肿瘤)的相似表现以及临床医生对该疾病的了解有限而受到混淆。GM对少数族裔女性的影响尤为严重,进一步加剧了在乳腺疾病护理方面本就处于不利地位的人群的健康差距。诊断的第一步是超声检查,随后进行粗针活检,结果显示为肉芽肿性炎症。在较小程度上,乳腺X线摄影和磁共振成像(MRI)可能有助于缩小鉴别诊断范围。需要高度的临床怀疑指数和多学科方法。克氏棒状杆菌的存在可能提示肉芽肿性乳腺炎的一种亚型,称为囊性中性粒细胞性肉芽肿性乳腺炎;疾病分层和个体化治疗即将出现。

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