肉芽腫性乳腺炎的病理是什么
肉(rou)芽腫性(xing)乳(ru)腺(xian)(xian)炎(yan)是一種罕見的慢性(xing)炎(yan)癥(zheng)疾病,僅是于乳(ru)腺(xian)(xian)小(xiao)葉和(he)非干酪樣壞(huai)死,也稱為(wei)肉(rou)芽腫性(xing)小(xiao)葉乳(ru)腺(xian)(xian)炎(yan)和(he)特(te)發性(xing)肉(rou)芽腫性(xing)乳(ru)腺(xian)(xian)炎(yan) 它在育(yu)(yu)齡婦女中較常見,有生育(yu)(yu)或多(duo)產和(he)母乳(ru)喂養史。你(ni)了(le)解過它的病理是什(shen)么嗎(ma)?下面就(jiu)來說(shuo)說(shuo),肉(rou)芽腫性(xing)乳(ru)腺(xian)(xian)炎(yan)的病理是什(shen)么,一定要注意。
肉芽腫性乳腺炎(yan)的(de)病理是(shi)什么
1、鏡下:
乳(ru)腺(xian)(xian)小葉結構(gou)(gou)尚有輪廓,低倍(bei)觀察(cha)乳(ru)腺(xian)(xian)小葉有肉芽腫(zhong),有的(de)相互(hu)融(rong)和。高倍(bei)觀察(cha)有異物型多(duo)核(he)巨細(xi)(xi)胞(bao)、上(shang)皮樣細(xi)(xi)胞(bao)、嗜酸(suan)性(xing)細(xi)(xi)胞(bao)、中(zhong)性(xing)白細(xi)(xi)胞(bao)、淋(lin)巴細(xi)(xi)胞(bao)等構(gou)(gou)成肉芽腫(zhong)病(bing)灶。肉芽腫(zhong)散在(zai)或大片壞死性(xing)融(rong)和可(ke)見多(duo)核(he)巨細(xi)(xi)胞(bao)反應,淋(lin)巴細(xi)(xi)胞(bao)及單核(he)細(xi)(xi)胞(bao)浸潤,部(bu)分可(ke)見嗜酸(suan)性(xing)粒(li)細(xi)(xi)胞(bao)浸潤、多(duo)伴有膿腫(zhong)形(xing)成。
2、肉眼:
腺(xian)體(ti)內大(da)小(xiao)不(bu)等的(de)腫(zhong)塊,無(wu)包膜,有的(de)切(qie)面呈實性,色(se)灰白(bai)、質硬,發污。散(san)在爛肉餡狀的(de)壞死(si)病灶,多發大(da)小(xiao)不(bu)等的(de)膿(nong)腫(zhong),米湯樣(yang)或黃白(bai)色(se)稠膿(nong),病變(bian)表現多種多樣(yang)。
肉芽(ya)腫(zhong)性乳腺炎的鑒別診(zhen)斷
肉芽(ya)腫(zhong)性乳腺(xian)(xian)炎好發(fa)(fa)于育齡(ling)期經產婦女(nv)(nv),有(you)(you)(you)哺(bu)乳史,在非(fei)哺(bu)乳期發(fa)(fa)病。部(bu)(bu)分患(huan)者(zhe)有(you)(you)(you)外傷、感(gan)染或(huo)服用女(nv)(nv)性激素藥物史。常發(fa)(fa)于單側乳腺(xian)(xian),也可(ke)雙側同時(shi)或(huo)異時(shi)發(fa)(fa)生。病變(bian)位置在乳腺(xian)(xian)的外周部(bu)(bu),以外上象(xiang)限(xian)為(wei)多見(jian),腫(zhong)塊大者(zhe)可(ke)累及(ji)整個(ge)。初(chu)起腫(zhong)塊不痛(tong)或(huo)微(wei)痛(tong),表(biao)面(mian)皮(pi)膚不紅或(huo)者(zhe)微(wei)紅,腫(zhong)塊質(zhi)硬,很少伴(ban)有(you)(you)(you)惡寒(han)發(fa)(fa)熱等全身癥狀。隨著病程漸(jian)長(chang),腫(zhong)塊可(ke)增大迅速,累及(ji)多個(ge)象(xiang)限(xian),邊界不清,表(biao)面(mian)不光滑,可(ke)與(yu)皮(pi)膚或(huo)周圍組織粘連,局(ju)部(bu)(bu)皮(pi)膚可(ke)出(chu)現紅腫(zhong),疼痛(tong),可(ke)伴(ban)有(you)(you)(you)同側腋(ye)窩淋(lin)巴結腫(zhong)大,少數可(ke)伴(ban)有(you)(you)(you)發(fa)(fa)熱;若不及(ji)時(shi)治療,可(ke)出(chu)現的膿腫(zhong),潰破流膿,形(xing)成竇道,經久不愈。乳腺(xian)(xian)彩超(chao)、鉬靶x線檢查無特異性,腫(zhong)塊期易與(yu)乳腺(xian)(xian)癌混淆(xiao),粗(cu)針穿(chuan)刺活檢有(you)(you)(you)助于鑒別診斷。
漿細胞性乳腺炎(yan)與肉芽腫性乳腺炎(yan)的區(qu)別
漿細胞(bao)性(xing)乳(ru)腺炎與肉芽腫(zhong)(zhong)(zhong)性(xing)乳(ru)腺炎有(you)不(bu)少的相似之(zhi)處,如臨(lin)床(chuang)表現(xian)為慢性(xing)乳(ru)腺炎,好發于非(fei)哺(bu)乳(ru)期(qi)女性(xing),可(ke)(ke)出現(xian)腫(zhong)(zhong)(zhong)塊(kuai)、膿(nong)腫(zhong)(zhong)(zhong)、竇道等癥狀(zhuang),但(dan)兩者(zhe)(zhe)的發病原因不(bu)同,臨(lin)床(chuang)表現(xian)又有(you)所(suo)不(bu)同。漿細胞(bao)性(xing)乳(ru)腺炎患(huan)者(zhe)(zhe)多數有(you)內(nei)陷病史;病變(bian)主要累(lei)及(ji)、乳(ru)暈(yun)的大導(dao)管(guan),故病變(bian)位(wei)置在乳(ru)暈(yun)區;溢液(ye)多見(jian),為漿液(ye)性(xing)或膿(nong)性(xing),可(ke)(ke)伴有(you)粉(fen)刺樣(yang)分(fen)泌物;腫(zhong)(zhong)(zhong)塊(kuai)紅腫(zhong)(zhong)(zhong)疼痛(tong),破潰后膿(nong)中夾雜脂質(zhi)樣(yang)物質(zhi),常(chang)反復發作,可(ke)(ke)形成瘺(lou)管(guan),常(chang)與輸乳(ru)孔相通;B超(chao)顯示(shi)低(di)回聲腫(zhong)(zhong)(zhong)塊(kuai)影及(ji)乳(ru)腺導(dao)管(guan)擴張(zhang);病理切片檢查可(ke)(ke)見(jian)擴張(zhang)的大導(dao)管(guan)及(ji)導(dao)管(guan)周圍(wei)漿細胞(bao)浸潤。
以上就(jiu)是關于肉芽腫(zhong)性乳(ru)腺炎(yan)的(de)病(bing)(bing)理是什么的(de)相關介紹,相信(xin)大家對此都(dou)有了(le)一定的(de)了(le)解。肉芽腫(zhong)性乳(ru)腺炎(yan)容(rong)易(yi)與其他(ta)病(bing)(bing)癥混(hun)淆,我們對此要有自(zi)己(ji)的(de)認識(shi)。此病(bing)(bing)癥的(de)發病(bing)(bing)率已經(jing)逐年提升,發現問(wen)題要及時治療。