肉芽肿性小叶性乳腺炎研究进展

Progress of research into granulomatous lobular mastitis

肉芽肿性小叶性乳腺炎(granulomatous lobular mastitis,GLM)是一种临床少见疾病,发病率逐年上升,但病因及发病机制尚不明确。其临床表现多样,组织病理学特征性表现为以乳腺小叶单位为中心的非干酪样肉芽肿病变。治疗手段包括随访观察、药物治疗以及手术,临床上常多种治疗方式联合应用。GLM病程长,易反复发作,迁延不愈,破坏乳房外形,严重影响患者身心健康。在目前的临床实践中,其诊断容易混淆,最佳治疗方式尚未统一。本文对GLM的病因、发病机制、临床表现、诊断以及治疗等内容进行阐述,并对其进行临床分型旨为临床诊疗提供参考。

Granulomatous lobular mastitis(GLM)is a rare clinical disease.The incidence has increased in recent years,but its etiology and pathogenesis are still unclear.GLM has a large variety of clinical manifestations and is characterized histologically by noncaseating granulomas which are of a lobulo-centric pattern and often associated with microabscess formation.Treatment includes observation,medication and surgery,however,many patients require more than one treatment modality.In spite of being a benign disease,it seriously damages the shape of the breast,has a long course,a high incidence of relapse and delayed recovery.Diagnosis can be confusing and there is no consensus regarding the optimal treatment.We describe the relevant epidemiological and histopathological factors and discuss the associated pitfalls and management.A proposal of clinical classification is also recommended to guide clinical practice.