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乳腺原发淋巴瘤误诊为乳腺癌原因分析及鉴别诊断OA

Causes of misdiagnosis of primary breast lymphoma as breast cancer and differential diagnosis

中文摘要英文摘要

目的 探讨乳腺原发淋巴瘤(PBL)误诊为乳腺癌的原因及鉴别诊断要点.方法 回顾性分析2022年4月—2024年10月收治的4例误诊为乳腺癌的PBL患者临床资料.结果 4例PBL患者均因乳腺肿块就诊,结合查体及相关检查初步诊断为乳腺癌,其中左侧乳腺癌2例、左侧乳腺癌伴左侧腋窝淋巴结转移1例、右侧乳腺癌1例.4例患者均接受手术治疗,术后病理与免疫组织化学检查确诊为PBL,其中B细胞非霍奇金淋巴瘤Ⅱ期3例、Ⅲ期1例.误诊时间5~40(16.36±2.89)d.术后给予放疗、化疗辅助治疗.术后随访3~22(11.69±2.30)个月,3例存活,1例术后1年复发后死亡.结论 PBL缺乏特异性临床表现,且相关医技检查结果较复杂,易误诊为乳腺癌,建议临床加强对PBL的辨识能力,诊断时应结合患者病史、体格检查及相关医技检查结果进行全面分析,仔细鉴别诊断,对于可疑病例及时行乳房肿物穿刺活组织病理及免疫组织化学检查,以降低误诊率.

Objective To investigate the causes of misdiagnosis of primary breast lymphoma(PBL)as breast cancer and essential points for differential diagnosis.Methods A retrospective analysis was conducted on the clinical data of 4 patients with PBL misdiagnosed as breast cancer who were admitted to the hospital from April 2022 to October 2024.Results All of the 4 patients with PBL visited the hospital due to breast masses and were initially diagnosed as breast cancer through physical examination and relevant examinations,including 2 cases of left-sided breast cancer,1 case of left-sided breast cancer with left axillary lymph node metastasis,and 1 case of right-sided breast cancer.All 4 patients underwent surgical treatment and were diagnosed with PBL by postoperative pathology and immunohistochemistry.Among them,there were 3 cases of stage II B-cell non-Hodgkin lymphoma and 1 case of stage III.The time of misdiagnosis ranged from 5 to 40 d,with an average of(16.36±2.89)d.Patients were given adjuvant radiotherapy and chemotherapy after surgery.The patients were followed up for 3-22(11.69±2.30)months.Of them,3 patients survived,while 1 patient died after recurrence at 1 year postoperatively.Conclusion PBL lacks specific clinical manifestations,and related medical examination results are complex,making it prone to misdiagnosis as breast cancer.It is recommended to enhance clinical recognition of PBL.Comprehensive analysis combining medical history,physical examination,and relevant laboratory and imaging findings should be conducted during diagnosis,along with careful differential diagnosis.Timely breast mass biopsy with pathological and immunohistochemical examinations should be conducted for suspicious cases to reduce the misdiagnosis rate.

张振宇;刘政锐;李超;王福凯;田照坤;刘晓宇;于志勇

山东第一医科大学(山东省医学科学院),济南 250117||山东省肿瘤医院(山东第一医科大学附属肿瘤医院)乳腺中心乳腺外科三病区,济南 250117山东第一医科大学(山东省医学科学院),济南 250117||山东省肿瘤医院(山东第一医科大学附属肿瘤医院)乳腺中心乳腺外科三病区,济南 250117山东省肿瘤医院(山东第一医科大学附属肿瘤医院)乳腺中心乳腺外科三病区,济南 250117山东省肿瘤医院(山东第一医科大学附属肿瘤医院)乳腺中心乳腺外科三病区,济南 250117山东省肿瘤医院(山东第一医科大学附属肿瘤医院)乳腺中心乳腺外科三病区,济南 250117山东省肿瘤医院(山东第一医科大学附属肿瘤医院)乳腺中心乳腺外科三病区,济南 250117山东省肿瘤医院(山东第一医科大学附属肿瘤医院)乳腺中心乳腺外科三病区,济南 250117

乳腺原发淋巴瘤误诊乳腺肿瘤鉴别诊断病理学免疫组织化学

primary breast lymphomamisdiagnosisbreast cancerdifferential diagnosispathologyimmunohistochemistry

《临床误诊误治》 2026 (6)

21-25,5

10.3969/j.issn.1002-3429.2026.06.004

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