肉芽肿性小叶性乳腺炎106例临床病理特征及病因分析

发布时间：2018-09-09 11:43

【摘要】：目的探讨肉芽肿性小叶性乳腺炎(granulomatous lobular mastitis,GLM)的临床病理学特征,并分析其与非结核分枝杆菌(nontuberculous mycobacteria,NTM)感染的相关性。方法对106例已经确诊的GLM重新阅片,并行金胺O、PASM、PAS特殊染色及荧光定量PCR检测。结果106例GLM均为女性,平均年龄33岁,有生育史及哺乳史104例,97例距末次妊娠3年发病,平均病程3个月。镜下组织学特征以乳腺终末导管小叶单位为中心的慢性化脓性肉芽肿性炎症。荧光定量PCR检测结核/NTM均阴性,PASM、PAS特殊染色未查见真菌,金胺O特殊染色1分15例、2分3例,金胺O染色阴性88例,阳性率为16.98%。18例金胺O染色阳性患者随访发现伴窦道形成5例,手术切口愈合差者2例,在1年内复发5例;88例金胺O染色阴性患者伴窦道形成14例,手术切口愈合差者5例,在3个月内复发5例。结论GLM是少见的良性炎症性乳腺疾病,NTM感染可能是GLM的病因之一,将金胺O、PASM、PAS特殊染色及荧光定量PCR联合检测可作为GLM的常规检查,为治疗GLM提供病理学依据。
[Abstract]:Objective to investigate the clinicopathological features of granulomatous lobular mastitis (granulomatous lobular mastitis,GLM) and its correlation with non-tuberculous Mycobacterium tuberculosis (nontuberculous mycobacteria,NTM) infection. Methods 106 cases of confirmed GLM were examined by special staining of Osmon pas and fluorescence quantitative PCR. Results all the 106 cases of GLM were female with an average age of 33 years. There were 97 cases with history of birth and lactation. The mean course of disease was 3 months after the last trimester of pregnancy. Histologic features of chronic suppurative granulomatous inflammation centered on the terminal ductal lobules of the mammary gland. No fungi were detected by fluorescence quantitative PCR in the pASMMA-PAS staining of tuberculous / NTM negative, there were 15 cases with gold amine O special staining, 3 cases with gold amine O staining, 88 cases with negative gold amine O staining. The positive rate was 16.980.18 cases of positive patients with positive gold amine O staining found 5 cases of sinus formation. There were 2 cases of poor healing of surgical incision, 5 cases of recurrence within one year, 14 cases of negative staining of gold amine O with sinus formation, 5 cases of poor healing of surgical incision, 5 cases of recurrence within 3 months. Conclusion GLM infection may be one of the etiology of GLM, which is a rare benign inflammatory mammary gland disease. The combination of Osmon pas special staining and fluorescence quantitative PCR can be used as the routine examination of GLM and provide pathological basis for the treatment of GLM.
【作者单位】： 福州市第八医院病理科;福建省妇幼保健院病理科;解放军福州总医院病理科;
【基金】：2016年度福建省科技厅引导性项目(2016D004) 福州市科技局社会发展项目(2015-S-148)
【分类号】：R655.8
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本文编号：2232273