浆细胞性乳腺炎58例诊治体会

Diagnostic and therapeutic experience of plasma cell mastitis

目的总结浆细胞性乳腺炎的临床特点及诊治要点。方法收集我院2004年9月至2010年12月间收治的浆细胞性乳腺炎患者58例,分析其临床、辅助检查特点。结果 45岁以下患者41例(70.7%),肿瘤位于左侧者37例(63.8%)。临床均有包块,21例(36.2%)伴非周期性疼痛,14例(24.1%)消炎治疗有一过性好转;血像无异常;钼靶摄影见腺体密度明显增高影或肿块,可伴颗粒状圆形钙化影。彩超见边缘模糊的多灶液性暗区。临床术前诊断疑癌5例(8.6%)。术中冰冻及术后石蜡诊断为浆细胞性乳腺炎,术后愈合良好。结论浆细胞性乳腺炎临床有包块,不伴周期性疼痛,消炎治疗有一过性好转,钼靶及彩超都有一定特点。结合临床及影像诊断可提高诊断可靠性,但术中送冰冻及术后石蜡是最准确的诊断途径,同时手术又是彻底治疗的最有效途径。

Objective To summarize the clinical characters and the main points of the diagnosis and treatment of plasma cell mastitis.Methods The clinical and auxiliary examined data of 58 patients with plasma cell mastitis in our hospital from September 2004 to December 2010 were analyzed.Results Of the 58 patients,41（70.7%） were below 45 years old,37（63.8%） had tumors in the left breast.All the cases had mass,21（36.2%） were complicated with aperiodic pain,14（24.1%） were improved after anti-inflammatory treatment.Blood routine showed no abnormality.Mammography revealed that glandular density increased obviously or mass were observed,with granular round calcification.Ill-defined multifocal dark areas could be observed on color Doppler ultrasound.5 cases（8.6%） were diagnosed as suspected carcinoma before operation.The plasma cell mastitis was diagnosed through freezing slide in the operation and paraffin wax after surgery.All patients were healed after surgery.Conclusion The plasma cell mastitis is characterized by masses clinically with aperiodic pain,and could be improved through anti-inflammatory treatment.Freezing slide in the operation and paraffin wax slide after surgery would be the most precise method for pathologic diagnosis,and surgery is the most effective for the treatment.