25例肉芽肿性小叶性乳腺炎(IGM)患者临床病因调查分析

Investigation and analysis of clinical etiology of 25 patients with idiopathic granulomatous lobular mastitis

肉芽肿性小叶性乳腺炎是少见的、乳腺炎症疾病,治疗上没有共识,病因不明。在临床病因学调查中,发现IGM患者患侧乳头发育不良率非常高,占总患者的64%;本组为外科手术治疗,全部具备病理诊断。本组乳头发育不良患者表现为先天性,自幼存在。从胚胎发育学上,乳头发育不良可能存在后续小叶腺管发育不良的可能性。在乳汁淤积或泌乳素增高等不利条件下,乳腺腺管通畅障碍,导致IGM发生。乳头、乳管发育不良是IGM重要基础性病因之一。

Idiopathic granulomatous mastitis of breast is a rare benign inflammatory disease,there is no consensus agreement regarding its treatment and etiology.The goal of this study is to investigate the etiological factors of IGM with clinical data;the rate of nipple dysplasia was remarkable higher(64%).And all diagnosis is based on histology of surgical samples.Nipple dysplasia of our patients is represented as congenital,long-standing history since infant.From rule of embryonic development,the cells are responsible for nipple development as well as breast lobular duct development in sequence,which would result in high possible rate of dysplasia of breast lobular ducts after the nipple dysplasia.Under the condition of postpartum galactostasis or higher level of blood prolactin,breast lobular ducts with dysplasia become stagnant or obstructed,which is a vital step in IGM etiology.Nipple and lobular ducts dysplasia of breast should be one of basic etiological factors in IGM.