浆细胞性乳腺炎超声误诊分析

Analysis of Plasma Cell Mastitis Misdiagnosed by Ultrasound

目的探讨浆细胞性乳腺炎(plasma cell mastitis,PCM)超声误诊原因,提高诊治水平。方法对我院2008年1月—2016年12月收治的超声检查误诊为其他疾病的PCM 15例临床资料进行回顾性分析。结果本组误诊率为17.44%(15/86),误诊时间(5.32±1.32)d;误诊为乳腺纤维瘤、乳腺囊肿各4例,乳腺脓肿3例,乳腺癌、导管内乳头状瘤各2例。本组8例行穿刺细胞学检查,7例予肿块切除,均经病理检查确诊为PCM,其中3例予穿刺引流等对症治疗后好转出院;12例择期行手术切除,术后予常规治疗后痊愈出院。随访3个月~2年,所有患者均病情平稳,未复发。结论临床加强对PCM临床表现、体征及影像学检查结果的认识和了解,提高诊治水平,减少误诊误治。

Objective To investigate misdiagnosed causes of plasma cell mastitis（ PCM） in order to improve the diagnosis and treatment. Methods Clinical data of 15 patients with PCM misdiagnosed by ultrasound admitted during January2008 and December 2016 was retrospectively analyzed. Results The misdiagnosis rate was 17. 44%. Misdiagnosed time was（ 5. 32 ± 1. 32） d,Among the 15 patients,there were 4 patients misdiagnosed as having mammary fibroma,4 patients misdiagnosed as having breast cysts,3 patients misdiagnosed as having breast abscess,2 patients misdiagnosed as having breast cancer and 2 patients misdiagnosed as having intraductal papilloma. Cytological examination by puncture was performed in 8 patients,and other 7 patients underwent mass excision,and all patients were confirmed PCM by pathological examination. Among them,3 patients underwent symptomatic treatments such as puncture and drainage,and were discharged after conditions had been improved; 12 patients underwent selectively surgical resection and postoperatively symptomatic treatments,and then were discharged after having been cured. All patients were followed up for 3 months-2 years,all patients＇ conditions were stable without recurrence. Conclusion Clinicians should enhance understanding of clinical manifestation,signs and imaging results of PCM patients and improve diagnosis and treatment so as to reduce or avoid misdiagnosis and mistreatment of PCM.