摘要
目的探讨IgG4相关硬化性乳腺炎的临床病理学特征。方法报道1例罕见的IgG4相关硬化性乳腺炎,结合文献对其临床表现、组织形态、免疫组化特点及治疗和预后等进行分析。结果患者女性,50岁,查体发现右乳包块1周。镜下见乳腺小叶萎缩,小叶内及小叶间有大量的淋巴细胞、浆细胞和少许嗜酸性粒细胞浸润,并淋巴滤泡形成及片状纤维化。免疫组化:间质内淋巴细胞以CD3、CD4和CD8(+)为主,CD20散在(+);IgG4+的浆细胞86个/HPF,在IgG+的浆细胞中占59%。随访半年未见复发。结论 IgG4相关硬化性乳腺炎是一种非常罕见的疾病,可伴发全身系统性疾病,诊断多结合临床表现、影像学、实验室检查及组织病理学等进行综合分析。鉴别诊断包括硬化性淋巴细胞性乳腺炎、浆细胞性乳腺炎及淋巴瘤等。及时应用糖皮质激素可控制病情。
Objective To investigate the clinicopathological characteristics of IgG4 related sclerosing mastitis (IgG-4 SM). Methods One case of IgG-4 related sclerosing mastitis was reported with review of the literature. The clinical presentation, morphological appearance, prominent stromal sclerosis and loss of breast lobules, immunohistochemical features, therapy and prognosis were analyzed in this tumor. Results A 50-years-old woman presented with painless masses for a week. Histologically, the breast mass featured dense lymphoplasmacytic infiltrates. Immunohistochemically, lymphoid cells were positive for CD3, CD4, CD8 and CD20. The number of plasma cells positive for IgG4 was 86/HPFs. The number of plasma cells positive for IgG4 +/IgG + was 59 percent. In the follow up, no relapse was found after 6 months. Conclusions IgG4-related sclerosing mastitis is a very rare disease and sometimes accompanied by other components of IgG4-related sclerosing disease in various organs. Its correct diagnosis relies on clinicopathologic features, imaging findings and immunohistochemical phenotype. It is also needed to differentiate from sclerotic lymphocytic mastitis, plasma cell mastitis and lymphoma and so on. It can be controlled with prompt use of corticosteroids.
出处
《诊断病理学杂志》
CSCD
北大核心
2013年第9期576-580,共5页
Chinese Journal of Diagnostic Pathology