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狼疮性乳腺炎的影像学表现:病例研究的系统评价

Imaging Findings of Lupus Mastitis: A Systematic Review of Case Studies.

作者信息

Nagy Stephanie, Daniel Kitty, Kesselman Marc M

机构信息

Rheumatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, USA.

Radiology, Mount Sinai Medical Center, Miami, USA.

出版信息

Cureus. 2025 Feb 15;17(2):e79064. doi: 10.7759/cureus.79064. eCollection 2025 Feb.

DOI:10.7759/cureus.79064
PMID:40104478
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11913633/
Abstract

Lupus mastitis (LM) is a rare manifestation of systemic lupus erythematosus, resulting in an inflammatory process within the breast tissue. This condition presents diagnostic challenges due to its similarity to other breast pathologies, including infections and malignancies. Clinically, patients may exhibit symptoms such as breast pain, swelling, and erythema, often leading to further investigation through imaging and histopathological analysis. Given the absence of established clinical guidelines for LM, identifying the most effective imaging and laboratory techniques is essential for accurate diagnosis and treatment. In this paper, 32 patient case reports were analyzed, with 20 patients having previous diagnoses of lupus and 12 not previously diagnosed. The study population comprised 90.6% (n=29) women, with a mean age of 44 years and an average disease duration of 10 years. The majority of LM was unilateral, with 50% (n=16) of patients experiencing LM in the right breast, 31.2% (n=10) in the left breast, and 18.8% (n=6) bilaterally. The location varied to almost all quadrants of the breast. The rarity of LM contributes to clinician unawareness, often resulting in misdiagnosis and confusion. As there are currently no guidelines, in this study we examined the imaging findings of LM through a variety of modalities and reported a suggested clinical guideline to follow for the diagnoses of LM.

摘要

狼疮性乳腺炎(LM)是系统性红斑狼疮的一种罕见表现,可导致乳腺组织内的炎症过程。由于其与包括感染和恶性肿瘤在内的其他乳腺病变相似,这种情况带来了诊断挑战。临床上,患者可能会出现乳房疼痛、肿胀和红斑等症状,这通常会促使通过影像学和组织病理学分析进行进一步检查。鉴于目前尚无针对LM的既定临床指南,确定最有效的影像学和实验室技术对于准确诊断和治疗至关重要。本文分析了32例患者的病例报告,其中20例患者先前已被诊断为狼疮,12例此前未被诊断。研究人群中女性占90.6%(n = 29),平均年龄为44岁,平均病程为10年。大多数LM为单侧,50%(n = 16)的患者右乳出现LM,31.2%(n = 10)的患者左乳出现LM,18.8%(n = 6)的患者双侧出现LM。病变位置几乎遍布乳房的所有象限。LM的罕见性导致临床医生对此缺乏认识,常常导致误诊和混淆。由于目前没有指南,在本研究中,我们通过多种方式检查了LM的影像学表现,并报告了一份建议的临床指南以供LM的诊断参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/f5e7481778b5/cureus-0017-00000079064-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/fbf8f174fa01/cureus-0017-00000079064-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/832edd3ee125/cureus-0017-00000079064-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/946226a5cbbc/cureus-0017-00000079064-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/afcd545c670b/cureus-0017-00000079064-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/c1251bfdef0a/cureus-0017-00000079064-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/aea887d73341/cureus-0017-00000079064-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/f5e7481778b5/cureus-0017-00000079064-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/fbf8f174fa01/cureus-0017-00000079064-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/832edd3ee125/cureus-0017-00000079064-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/946226a5cbbc/cureus-0017-00000079064-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/afcd545c670b/cureus-0017-00000079064-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/c1251bfdef0a/cureus-0017-00000079064-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/aea887d73341/cureus-0017-00000079064-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba0/11913633/f5e7481778b5/cureus-0017-00000079064-i07.jpg

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本文引用的文献

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Lupus Mastitis: The Rare Mimic of Breast Malignancy.狼疮性乳腺炎:罕见的乳腺恶性肿瘤模仿者。
J Breast Imaging. 2024 Jan 19;6(1):109-111. doi: 10.1093/jbi/wbad050.
2
Diagnosis of lupus mastitis via multimodal ultrasound: case description.通过多模态超声诊断狼疮性乳腺炎:病例描述
Quant Imaging Med Surg. 2024 Apr 3;14(4):3235-3238. doi: 10.21037/qims-23-1279. Epub 2024 Mar 15.
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A mimicker of inflammatory breast carcinoma: Lupus mastitis and evolving imaging features.炎性乳腺癌的一种模拟者:狼疮性乳腺炎及其不断演变的影像学特征。
J Clin Ultrasound. 2023 Nov-Dec;51(9):1546-1548. doi: 10.1002/jcu.23573. Epub 2023 Sep 29.
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Rare and First Manifestation of Lupus Panniculitis as Lupus Mastitis: A Case Report and Literature Review.狼疮性脂膜炎作为狼疮性乳腺炎的罕见首发表现:一例报告及文献复习
Curr Med Imaging. 2023 Aug 4. doi: 10.2174/1573405620666230804092737.
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Unilateral lupus mastitis.单侧狼疮性乳腺炎
Lupus. 2023 Mar;32(3):438-440. doi: 10.1177/09612033221151011. Epub 2023 Jan 9.
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Lupus mastitis - the copycat.狼疮性乳腺炎——模仿者。
Scand J Rheumatol. 2023 Jan;52(1):88-90. doi: 10.1080/03009742.2022.2076348. Epub 2022 Jun 6.
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Lupus Mastitis in a Young Female Mimicking a Breast Carcinoma; a Rare Entity Through a Case Report and Review of the Literature.一名年轻女性的狼疮性乳腺炎酷似乳腺癌;通过病例报告及文献复习探讨这一罕见病例
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Syst Rev. 2021 Mar 29;10(1):89. doi: 10.1186/s13643-021-01626-4.
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