Kazi Farah F, Batool Shane Zahra, Kazi Ahmed, Bashir Yasir
General Surgery, Midland Regional Hospital Tullamore, Tullamore, IRL.
Surgery, Tullamore Hospital, Tullamore, IRL.
Cureus. 2024 Aug 23;16(8):e67601. doi: 10.7759/cureus.67601. eCollection 2024 Aug.
Breast abscesses are a common cause of presentation to the hospital. These should be treated with caution due to the possibility of rare pathology. We present a rare case of a 59-year-old diabetic gentleman who presented to the emergency department with a two-day history of a large right-sided breast swelling along with an area of induration, consistent with an abscess, extending to the right axillary region. Initial laboratory findings revealed elevated inflammatory markers. He was admitted for intravenous antibiotics. A computed tomography (CT) of the thorax performed on admission showed an ill-defined collection in the subcutaneous tissue of the right breast and axilla and an irregular right-sided peribronchial nodule with multiple enlarged pathological lymph nodes. This patient's case was discussed with tertiary specialist breast services and local respiratory teams. He underwent an ultrasound-guided right axillary lymph node biopsy. The histopathology of this revealed a high-grade malignant non-Hodgkin's lymphoma of the diffuse large B-cell (DLBCL) type. He was referred for a positron emission tomography (PET) scan and hematological oncology services for further treatment in the form of chemotherapy. This case presentation brings forward the importance of considering rare diagnoses and unusual histopathology when assessing a male breast lesion.
乳腺脓肿是患者前往医院就诊的常见原因。由于可能存在罕见病理情况,对此应谨慎治疗。我们报告一例罕见病例,一名59岁的糖尿病男性患者因右侧乳房大面积肿胀伴硬结区域(与脓肿相符)、硬结延伸至右侧腋窝区域,有两天病史,前往急诊科就诊。初步实验室检查结果显示炎症指标升高。他因静脉注射抗生素入院。入院时进行的胸部计算机断层扫描(CT)显示右侧乳房和腋窝皮下组织有边界不清的积液,以及右侧不规则的支气管周围结节伴多个肿大的病理性淋巴结。该患者的病例与三级专科乳腺服务团队和当地呼吸科团队进行了讨论。他接受了超声引导下的右侧腋窝淋巴结活检。活检组织病理学显示为弥漫性大B细胞型(DLBCL)高级别恶性非霍奇金淋巴瘤。他被转介进行正电子发射断层扫描(PET)并接受血液肿瘤学服务,以便接受化疗形式的进一步治疗。该病例报告凸显了在评估男性乳腺病变时考虑罕见诊断和不寻常组织病理学的重要性。