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題名 | 糖尿病乳房病變:個案報告並文獻回顧=Diabetic Mastopathy: A Case Report and Review of the Literature |
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作者姓名(中文) | 陳素榆; 李勃興; 周劍文; 楊純宜; 鄭弘美; | 書刊名 | 內科學誌 |
卷期 | 13:6 2002.12[民91.12] |
頁次 | 頁308-312 |
分類號 | 415.668 |
關鍵詞 | 糖尿病乳房病變; 第一型糖尿病; Diabetic mastopathy; Type 1 DM; |
語文 | 中文(Chinese) |
中文摘要 | 一名27歲女性,自國中三年級即因糖尿病開始接受胰島素注射。病人一天僅施 打一次胰島素,且飲食控制的觀念並不充分,所以長期血糖控制並不良好。27歲時來門診時眼睛已因增殖性視網膜病變接受了三次光凝固法治療。腎臟病變方面,24小時肌酸酐廓清率為22.4ml/min;24小時尿蛋白流失為7570 mg/day。丙型結合 鏈(C-peptide)值小於0.5 ng/m1。在門診追蹤數月之後,病人在左乳摸到一個無痛性可移動的硬塊,接受乳房超音波檢查後,發現一低回音界限不明,且後方有無回音陰影的腫塊。切片檢查顯示除乳房組織基質出現纖維化的變化外,乳腺管及血管旁有豐富的淋巴球浸潤,故診斷為糖尿病乳房病變。病人七個月後追蹤乳房超音波在右乳又發現另一個相似的腫塊,切片檢查也顯示同樣的病理變化。糖尿病乳房病變為一良性變化,但在臨床觸診及影像檢查上不易與惡性腫瘤區分,細針穿刺又不一定得到滿意的結果。處理糖尿病人的乳房腫塊時,臨床醫師實需將此病加以考慮。借此機會回顧文獻以為借鏡。 |
英文摘要 | Diabetic mastopathy is an unusual fibroinflammatory breast lesion affecting patients with a history of long-standing type 1 diabetes mellitus. At the time of presentation with breast symptoms, the patients often have associated chronic complication. We report a case of 29-years-old woman who found a painless mass in the left breast. Mammogram revealed very dense breast parenchyma. Breast sonography demonstrated an irregular hypoechoic lesion with posterior acoustic shadow. She underwent core biopsy. Microscopic examination showed lymphocytic infiltration in the ductules with dense stroma fibrosis, which were compatible with diabetic mastopathy. Recent reports of this literature about diabetic mastopathy were reviewed. |
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