摘要：眾所周知幹燥綜合征主要累及外分泌腺，尤其是淚腺和唾液腺，乳腺的解剖學、組織學、免疫學特征與之有相似之處。為此我們研究了幹燥綜合征患者的乳腺受累情況，與小涎腺受累的組織病理進行比較。我們回顧分析了具有小唾液腺和乳腺病理組織的幹燥綜合征患者資料(2000年1月至2015年1月在蒙彼利埃大學醫院隨訪)。兩位病理學家對這些組織進行了回顧性分析，以確定炎症模式。進行免疫組化染色來確定精確的白細胞分布情況。共納入16例具有唾液腺和乳腺組織標本的幹燥綜合征患者。均為女性，幹燥綜合征診斷的中位年齡60.1±11.3歲。6例患者因具有乳腺症狀而進行了乳腺活檢，10例患者進行了乳腺癌的相關影像篩查。9例患者呈現炎性乳腺模式(淋巴細胞浸潤或導管擴張症)，與小唾液腺的組織學表現相似。免疫組織化學染色(N = 5)顯示乳腺組織內有B和T細胞浸潤，CD4 +T細胞比例更高，但未發現分泌IgG4的漿細胞。這是描述幹燥綜合征患者乳腺炎症形式的首個病例研究。乳腺炎與這種疾病的外分泌腺受累是一致的。這些發現與認為幹燥綜合征是“自身免疫性皮炎”的文獻數據一致。
附原文:Abstract Sjögren's syndrome is well known to target exocrine glands, especially lacrimal and salivary glands, which share with mammary glands anatomical, histological, and immunological features. Herein, we investigated the mammary involvement in patients with Sjögren's syndromeand compared the histological findings with minor salivary gland involvement. We reviewed the charts of patients with Sjögren's syndrome(followed in Montpellier University Hospital, between January 2000 and January 2015), in whom minor salivary gland and mammary tissues were available. Two expert pathologists analysed retrospectively these tissues in order to identify inflammatory patterns. Immunohistochemicalstainings were performed to precise leucocyte distribution. Sixteen Sjögren's syndrome patients with available salivary and breast tissue samples were included. All were women, with a median age of 60.1 ± 11.3 years at Sjögren's syndrome diagnosis. Mammary biopsy was conducted because
of breast symptoms in 6 patients and following imaging screening strategies for breast cancer in 10 patients. Nine patients exhibited an inflammatory breast pattern (lymphocytic infiltrates or duct ectasia), close to minor salivary gland histological findings. Immunohistochemicalstainings (n = 5) revealed B and T cell infiltrates within breast tissue, with a higher proportion of T CD4+ cells, but no IgG4-secreting plasma cells were found. This is the first series to describe breast inflammatory patterns in Sjögren's syndrome. Mastitis is in line with the classical involvement of exocrine glands in this disease. These findings are consistent with the literature data considering Sjögren's syndrome as an "autoimmune epithelitis".
引自：Goulabchand R,Hafidi A,Millet I,Morel J,Lukas C,Humbert S,Rivière S,Gény C,Jorgensen C,Le Quellec A,Perrochia H,Guilpain P.Mastitis associated with Sjögren's syndrome: a series of nine cases. Immunol Res. 2017;65(1):218-229.
