Mastitis granulomatosa: experiencia diagnóstica y terapéutica multidisciplinaria del Hospital Argerich de Buenos Aires

IF 0.2 Q4 OBSTETRICS & GYNECOLOGY
Gustavo Fernández , Ingrid Sehringer , Eliana Blanco , Mariela Fernández , Darío Mata
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引用次数: 0

Abstract

Introduction

Granulomatous mastitis is a chronic inflammatory disease that presents as a painful breast mass, associated with abscesses and fistulas, which can mimic carcinoma. Etiology is still unclear, and an autoimmune response related to Corynebacterium is postulated. There are no diagnostic guidelines or therapeutic algorithms. In our study we analyzed the clinical presentations, images, cultures, and pathological findings together with the treatments, results, and evolution.

Material and methods

We carried out a descriptive, retrospective, and observational study of patients diagnosed with granulomatous mastitis treated in our hospital in the period 2017-2022.

Results

51 women. Average age 38.1 years. Pregnancies and Lactation 88.2%. Clinic: Abscessed and/or fistulized palpable mass 74.5%, painful palpable mass 13.8%. Asymptomatic mass 11.7%. Erythema Nodosum 11.7% BIRADS images 4/5: 82.3%. Average size: 3.54 cm. Pathology: Cystic vacuoles associated with Corynebacterium in 24 biopsies (47.1%). Bacteriology: positive cultures for Corynebacterium in 13 of 47 samples (27.6%). Treatment: antibiotic therapy 92.1%, immunosuppression 78.4%, surgical treatment 60.7%. Mean time of immunosuppression with corticosteroids 7.09 months and with methotrexate 9.27 months. Complications: 9.8% Aesthetic sequelae: 39.2% Disease-free time: 14.04 months. Recurrences: 13.7%.

Conclusions

The bacteriological and pathological search for Corynebacterium and a patient tailor made multidisciplinary approach is essential to achieve therapeutic success.

肉芽肿性乳腺炎:布宜诺斯艾利斯Argerich医院的多学科诊断和治疗经验
肉芽肿性乳腺炎是一种慢性炎症性疾病,表现为疼痛的乳房肿块,伴有脓肿和瘘管,可模仿癌症。病因尚不清楚,推测与棒状杆菌相关的自身免疫反应。目前还没有诊断指南或治疗算法。在我们的研究中,我们分析了临床表现、图像、培养和病理结果,以及治疗、结果和演变。材料与方法我们对2017-2022年在我院治疗的肉芽肿性乳腺炎患者进行了描述性、回顾性和观察性研究。Results51女性。平均年龄38.1岁。妊娠和哺乳期88.2%。临床:脓肿和/或瘘管可触及肿块74.5%,痛性可触及肿块13.8%。无症状肿块11.7%。BIRADS影像4/5:82.3%。平均尺寸:3.54厘米。病理:24例活检中出现囊泡伴棒状杆菌(47.1%)。细菌学:47份样本中有13份杆状杆菌培养阳性(27.6%)。治疗:抗生素治疗92.1%,免疫抑制78.4%,手术治疗60.7%。皮质激素组免疫抑制的平均时间为7.09个月,甲氨蝶呤组为9.27个月。并发症:9.8%美观后遗症:39.2%无病时间:14.04个月。递归:13.7%。结论杆状芽孢杆菌的细菌学和病理学研究以及患者量身定制的多学科方法是获得治疗成功的关键。
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来源期刊
Revista de Senologia y Patologia Mamaria
Revista de Senologia y Patologia Mamaria Medicine-Obstetrics and Gynecology
CiteScore
0.30
自引率
0.00%
发文量
74
审稿时长
63 days
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