浆细胞性乳腺炎的诊断和治疗(附124例临床分析)

Diagnosis and treatment of plasma cell mastitis:a report of 124 cases

目的探讨浆细胞性乳腺炎的临床、病理特点及诊治方法。方法回顾性分析124例浆细胞性乳腺炎患者的临床资料。结果乳头发育不良(乳头内陷加分叶状乳头)74例(59.64%);临床表现为炎性肿块型66例(53.23%),无痛性肿块型38例(30.65%),慢性瘘管型20例(16.13%);误诊为急性细菌性乳腺炎13例(10.48%),乳腺癌7例(5.64%);手术切除病灶120例(96.77%),其中术后7例(5.65%)切口感染。结论浆细胞性乳腺炎肿块形成时极易误诊为乳腺癌;伴有细菌感染时又极易与一般的感染性乳腺炎混淆;乳头发育不良可能是引起该病的一个重要原因;正确选择手术时机及彻底切除病灶是治疗成功的关键。

Objective To summarize the pathogenesis, clinical features, diagnosis and treatment of plasma cell mastitis. Methods The clinical data of 124 patients with plasma cell mastitis were retrospectively analyzed. Results There were 74 cases of mammary papilla dysplasia （mammary papilla invagination and foliatepapilla） （59.64 % ）, 66 cases of inflammatory lump （53.23 % ） ,20 cases of chronic fistula eannulas （16.13 % ） （including 13 cases misdiagnosed as acute bacteria mastitis and 7 cases as breast cancer）. 120 patients received resection of the suffered lobe and 7 cases had infection of incisional wound after operation. Conclusion In patients with plasma cell mastiris, lump was easily misdiagnosed as breast cancer and infection was easily misdiagnosed as bacteria mastitis. Mammary papilla dysplasia may be the major etiological factor. A proper surgical procedure is the key point to get a good outcome.