Breast tuberculosis mimicking breast abscess in a healthy woman

건강한 18세 여자에서 유방 농양으로 오인된 유방 결핵 1예

  • Kim, Sun-Young (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Shin, Ju-Young (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Yeom, Ju-Ok (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Chough, Hong-Sung (Department of Internal Medicine, Chosun University College of Medicine) ;
  • Kim, Hyun-Sook (Department of Internal Medicine, Chosun University College of Medicine)
  • 김선영 (가톨릭대학교 의과대학 내과학교실) ;
  • 신주영 (가톨릭대학교 의과대학 내과학교실) ;
  • 염주옥 (가톨릭대학교 의과대학 내과학교실) ;
  • 조홍성 (조선대학교 의과대학 내과학교실) ;
  • 김현숙 (조선대학교 의과대학 내과학교실)
  • Received : 2009.03.04
  • Accepted : 2009.07.06
  • Published : 2010.07.01

Abstract

Breast tuberculosis is a rare form of tuberculosis (TB). In healthy individuals in developed countries, the incidence is <0.1% of breast lesions examined histologically. The significance of breast TB is due to its rare occurrence and mistaken identity with breast cancer or pyogenic breast abscess. We report the case of an 18-year-old healthy woman diagnosed with breast TB that mimicked breast abscess. She was admitted for multiple erythema nodosum (EN) of the lower extremities of 6 weeks duration. She also noticed a painful oral ulcer and a palpable nodule with fistula on the right breast for 8 weeks. Our patient had the characteristic radiological and histopathological features of breast TB. Breast abscess and EN improved after antitubercular medication, including isoniazid, rifampin, ethambutol and pyrazinamide.

최근 인간 면역 결핍 바이러스 감염에 의한 면역 저하자가 늘면서 폐외 결핵의 유병률이 높아지는 것으로 알려져 있으나 유방 결핵은 발생 빈도가 낮고, 면역기능에 이상이 없는 건강한 사람에게서의 발생은 더욱 드물다. 저자들은 인간 면역 결핍 바이러스 감염과 같은 면역 저하없이 양측 하지에 오른쪽 유방에서 누공이 있는 농양과 지속적인 결절 홍반을 보인 18세 환자를 유방 결핵으로 진단하고 성공적으로 치료한 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Kasper DL, Braunwald E, Fauci AS, etc. Harrison's internal medicine. 16th ed. p. 957, New York, McGraw-Hill, 2005
  2. 서영진, 박우배, 문인성, 김준기, 전정수. 유방 결핵 2예. 외과학회지 47:595-602, 1994
  3. Lai-Cheong JE, Perez A, Tang V, Martinez A, Hill V, Menage Hdu P. Cutaneous manifestations of tuberculosis. Clin Exp Dermatol 32:461-466, 2007 https://doi.org/10.1111/j.1365-2230.2007.02352.x
  4. Tewari M, Shukla HS. Breast tuberculosis: diagnosis, clinical features and management. Indian J Med Res 122:103-110, 2005
  5. 권재홍, 조남천, 윤광수, 노병선, 김수용. 유방 결핵 3예 치험 보고. 외과학회지 42:856-861, 1992
  6. Khanna R, Prasanna GV, Gupta P, Kumar M, Khanna S, Khanna AK. Mammary tuberculosis: report on 52 cases. Postgrad Med J 78:422-424, 2002 https://doi.org/10.1136/pmj.78.921.422
  7. 김상희, 조경아, 권태형, 노병선, 김대성, 윤광수. 유방 결핵. 대한외과학회지 53:631-634, 1997
  8. Haris SH, Khan MA, Khan R, Haque F, Syed A, Ansari MM. Mammary tuberculosis: analysis of thirty-eight patients. ANZ J Surg 76:234-237, 2006 https://doi.org/10.1111/j.1445-2197.2006.03692.x
  9. Sklair-Levy M, Muggia-Sulam M, Mally B. Primary breast tuberculosis diagnosed by sonographically guided core-needle biopsy. J Ultrasound Med 25:1357-1360, 2006
  10. Requena L, Requena C. Erythema nodosum. Dermatol Online J 8:4, 2002
  11. Schwartz RA, Nervi SJ. Erythema nodosum: a sign of systemic disease. Am Fam Physician 75:695-700, 2007
  12. Gupta SN, Flaherty JP, Shaw JC. Erythema nodosum associatedwith reactivation tuberculous lymphadenitis (scrofula). Int J Dermatol 41:173-175, 2002 https://doi.org/10.1046/j.1365-4362.2002.01390.x
  13. Mert A, Ozaras R, Tabak F, Ozturk R. Primary tuberculosis cases presenting with erythema nodosum. J Dermatol 31:66-68, 2004
  14. Kroot EJ, Hazes JM, Colin EM, Dolhain RJ. Poncet's disease: reactive arthritis accompanying tuberculosis: two case reports and a review of the literature. Rheumatology 46:484-489, 2007 https://doi.org/10.1093/rheumatology/kel268