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一名年轻女性患者中与系统性红斑狼疮血清学阳性相关的肉芽肿性乳腺炎罕见病例:病例报告及文献综述

A Rare Case of Granulomatous Mastitis Associated With Positive Systemic Lupus Erythematosus Serology in a Young Female Patient: A Case Report and Literature Review.

作者信息

Abdalla Mohammed S, Saad Eltaib, Abdulrahman Ahmed, Abdulrahman Ahmed A, Mokhtar Mousab, Mohamed Khalid

机构信息

Internal Medicine, Ascension Saint Francis Hospital, Evanston, USA.

出版信息

Cureus. 2023 Jan 2;15(1):e33279. doi: 10.7759/cureus.33279. eCollection 2023 Jan.

Abstract

Granulomatous mastitis (GM) is a rare benign breast disease that affects women of childbearing age, usually within five years of pregnancy. The hallmark diagnostic feature of GM is the presence of lobular granulomatous inflammation. The occurrence of this clinicopathological entity is usually idiopathic. Nevertheless, GM has often been associated with systemic inflammatory conditions of either infectious (such as tuberculosis) or autoimmune etiology (particularly sarcoidosis, vasculitis, and less likely systemic lupus erythematosus [SLE]). In this report, the authors described an unusual case of GM that was associated with features of SLE in a young female patient who presented with a painful breast lump. Histopathological examination of the lump's biopsy showed GM. Further laboratory workup revealed evidence of some immunological criteria of SLE. Steroid therapy led to the resolution of the patient's breast swelling. The breast mass remained in remission with hydroxychloroquine treatment. Only a handful of similar cases in the current literature demonstrated a plausible association between SLE and GM. Our case provides a reference to consider SLE as a possible differential diagnosis when GM is encountered in young-aged female patients.

摘要

肉芽肿性乳腺炎(GM)是一种罕见的良性乳腺疾病,影响育龄女性,通常在怀孕后五年内发病。GM的标志性诊断特征是小叶性肉芽肿性炎症。这种临床病理实体的发生通常是特发性的。然而,GM常与感染性(如结核病)或自身免疫性病因(特别是结节病、血管炎,较少见系统性红斑狼疮[SLE])的全身性炎症性疾病有关。在本报告中,作者描述了一例不寻常的GM病例,该病例与一名年轻女性患者的SLE特征相关,该患者出现乳房疼痛性肿块。肿块活检的组织病理学检查显示为GM。进一步的实验室检查发现了SLE的一些免疫学标准证据。类固醇治疗使患者的乳房肿胀消退。羟氯喹治疗使乳房肿块保持缓解状态。目前文献中只有少数类似病例表明SLE与GM之间存在合理关联。我们的病例为在年轻女性患者中遇到GM时考虑SLE作为可能的鉴别诊断提供了参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c06a/9892233/d313534232e4/cureus-0015-00000033279-i01.jpg

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