PDF(Pubmed)
Abstract：
BACKGROUND: IgG4-related diseases are characterized by marked infiltration and IgG4-positive plasma cells and fibrosis, and involve multiple organs. However, IgG4-related mastitis is rare. We report a case of mastitis associated with IgG4-related disease.
METHODS: A 78-year-old woman visited our hospital with a complaint of multiple subcutaneous nodules. A biopsy of a dorsal subcutaneous mass was performed but did not yield a definitive diagnosis. However, blood tests showed a high level of IgG4, thus she was referred to the department of collagen disease for further examination. Computed tomography (CT) showed a thickening of the skin of the right breast, and the patient was referred to our department. On physical examination, a large area of thickened skin was observed in the right breast without inflammatory breast cancer-like redness, and no mass was palpable. A needle biopsy was performed on an indistinct hypoechoic area in the breast, and she was diagnosed with mastitis associated with IgG4-related disease. Systemic steroid therapy was then administered and the symptoms of multiple skin nodules and mastitis improved.
CONCLUSIONS: We reached the diagnosis based on a biopsy of the mammary gland enabling the patient to begin treatment for IgG4-related disease. This case was characterized by breast skin thickening, which is different from inflammatory breast cancer.
METHODS: A 78-year-old woman visited our hospital with a complaint of multiple subcutaneous nodules. A biopsy of a dorsal subcutaneous mass was performed but did not yield a definitive diagnosis. However, blood tests showed a high level of IgG4, thus she was referred to the department of collagen disease for further examination. Computed tomography (CT) showed a thickening of the skin of the right breast, and the patient was referred to our department. On physical examination, a large area of thickened skin was observed in the right breast without inflammatory breast cancer-like redness, and no mass was palpable. A needle biopsy was performed on an indistinct hypoechoic area in the breast, and she was diagnosed with mastitis associated with IgG4-related disease. Systemic steroid therapy was then administered and the symptoms of multiple skin nodules and mastitis improved.
CONCLUSIONS: We reached the diagnosis based on a biopsy of the mammary gland enabling the patient to begin treatment for IgG4-related disease. This case was characterized by breast skin thickening, which is different from inflammatory breast cancer.
摘要：
背景：IgG4相关疾病的特征是明显的浸润和IgG4阳性浆细胞和纤维化，涉及多个器官。然而,IgG4相关性乳腺炎是罕见的。我们报告一例与IgG4相关疾病相关的乳腺炎。
方法：一名78岁的妇女到我院就诊，主诉皮下多发结节。对背侧皮下肿块进行了活检，但未得出明确的诊断。然而,血液检查显示IgG4水平较高，因此她被转诊到胶原蛋白疾病部门进行进一步检查。计算机断层扫描（CT）显示右乳房皮肤增厚，病人被转诊到我们部门.在体检时，在右乳房观察到大面积皮肤增厚，没有炎性乳腺癌样发红，没有明显的肿块。对乳房中不明显的低回声区域进行了穿刺活检，她被诊断患有与IgG4相关疾病相关的乳腺炎。然后进行全身类固醇治疗，多个皮肤结节和乳腺炎的症状得到改善。
结论：我们基于乳腺活检使患者能够开始治疗IgG4相关疾病而获得诊断。这个病例的特点是乳房皮肤增厚,这与炎性乳腺癌不同。
方法：一名78岁的妇女到我院就诊，主诉皮下多发结节。对背侧皮下肿块进行了活检，但未得出明确的诊断。然而,血液检查显示IgG4水平较高，因此她被转诊到胶原蛋白疾病部门进行进一步检查。计算机断层扫描（CT）显示右乳房皮肤增厚，病人被转诊到我们部门.在体检时，在右乳房观察到大面积皮肤增厚，没有炎性乳腺癌样发红，没有明显的肿块。对乳房中不明显的低回声区域进行了穿刺活检，她被诊断患有与IgG4相关疾病相关的乳腺炎。然后进行全身类固醇治疗，多个皮肤结节和乳腺炎的症状得到改善。
结论：我们基于乳腺活检使患者能够开始治疗IgG4相关疾病而获得诊断。这个病例的特点是乳房皮肤增厚,这与炎性乳腺癌不同。
