手術後の病理検索にて確定診断された肉芽腫性乳腺炎の1例 A CASE REPORT OF GRANULOMATOUS MASTITIS DIAGNOSED BY HISTOPATHOLOGICAL STUDY AFTER OPERATION

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診断に苦慮し,手術標本の病理所見にて,はじめて診断しえた肉芽腫性乳腺炎の1例を報告する.症例は31歳,女性で, 2週間前から有痛性右乳腺腫瘤にて,近医で抗生物質投与をうけていたが軽快せず,当科を紹介された.触診では,右乳房AC領域に最大径7.5cmの熱感を伴う弾性硬の腫瘤が認められた.マンモグラフィでは腫瘤は非対称性陰影を示し,超音波検査では最大径約4cmの不整型低エコー腫瘤を認め,穿刺吸引細胞診,針生検では強い炎症像のみで悪性所見は認められなかった.抗生物質などを投与したが,同部に発赤,腫張が増強し,各種所見より炎症性乳癌も否定できず,全身麻酔下に腫瘤切除術を行った.手術所見では腫瘤部内には多房性の腫瘍形成が生じており,組織学的に乳腺小葉に限局して炎症細胞浸潤を伴う肉芽腫が認められた.ラングハンス巨細胞も浸潤しており,肉芽腫性乳腺炎と診断された. 6カ月を過ぎた現在,再発徴候なく外来観察中である.

We report a case of granulomatous mastitis which could be diagnosed by histopathological study after operation. A 31-year-old woman who had been administered antibiotics for a painful right breast tumor for 2 weeks elsewhere was referred to the hospital because the regimen was ineffective. An elastic- hard painful mass 7.5cm in diameter was palpable at the AC area of the right breast. Mammography showed a nonsymmetric tumor shadow and ultrasonography revealed an irregular hypo-echoic mass about 4cm in maximum diameter. Fine needle aspiration biopsy and core needle aspiration biopsy showed only inflammatory changes without malignancy. Despite administration of antibiotics for a week redness and swelling of the lesion increased. A possibility of inflammatory breast cancer could not be ruled out so that the tumor was removed under general anesthesia. The operative findings showed that the tumor composed of multilocular abscesses. Histopathological study revealed epithelioid cell granuloma with infiltration of inflammatory cells which was localized in the lobules of mammary gland, into where Langhans'-type giant cells also infiltrated. Therefore the tumor was definitely diagnosed as granulomatous mastitis.

収録刊行物

  • 日本臨床外科学会雑誌 = The journal of the Japan Surgical Association

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association 67(4), 759-762, 2006-04-25

    Japan Surgical Association

参考文献:  15件中 1-15件 を表示

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各種コード

  • NII論文ID(NAID)
    10018015177
  • NII書誌ID(NCID)
    AA11189709
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    13452843
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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