Hoang Huu, El-Helou Etienne, Pop Catalin-Florin, Shall Ammar, Zaiter Manar, Naccour Jessica, Nguyen Tran T H, Ho Xuan D, Nguyen Van C
Department of Oncology, Hue college of Medicine and Pharmacy-Hue University, Hue, Vietnam.
Department of Surgical Oncology, Institute Jules Bordet, Brussels, Belgium.
Surg J (N Y). 2022 Jun 14;8(2):e123-e126. doi: 10.1055/s-0042-1749123. eCollection 2022 Apr.
Primary breast tuberculosis (TB) is a rare extrapulmonary TB mainly affecting young women of childbearing age from endemic countries. Its incidence is increasing in immunocompromised and HIV-infected people and with the emergence of drug-resistant strains of (MTB). There are no specific clinical signs suggestive of this disease, it often presents as a hard mass or breast abscess. There is an overlap of features with other inflammatory, infectious, benign lesions, fat necrosis and malignant neoplasms of the breast. The detection of MTB remains the gold standard for diagnosis. Several other diagnostic modalities are used, with varying lack of sensitivity and specificity, and with a range of false negatives. A quarter of cases were treated solely on the basis of clinical, imaging or histological suspicion, without confirmation of the diagnosis. Therefore, we report the case of a young Vietnamese woman, presented for a nonhealing breast abscess, and diagnosed with breast TB based on the patient's ethnicity, histological findings, lack of clinical response to conventional antibiotic therapy, and a good clinical response to anti-TB treatment.
原发性乳腺结核是一种罕见的肺外结核,主要影响来自结核病流行国家的育龄年轻女性。在免疫功能低下和感染艾滋病毒的人群中,以及随着耐多药结核分枝杆菌菌株的出现,其发病率正在上升。这种疾病没有特定的临床症状,通常表现为硬块或乳腺脓肿。它与乳腺的其他炎症性、感染性、良性病变、脂肪坏死和恶性肿瘤有特征重叠。结核分枝杆菌的检测仍然是诊断的金标准。还使用了其他几种诊断方法,但其敏感性和特异性各不相同,且存在一系列假阴性。四分之一的病例仅根据临床、影像学或组织学怀疑进行治疗,而未确诊。因此,我们报告了一名年轻越南女性的病例,该患者因乳腺脓肿不愈合前来就诊,根据患者的种族、组织学检查结果、对传统抗生素治疗无临床反应以及对抗结核治疗有良好临床反应,被诊断为乳腺结核。