Introduction: The coexistence of tuberculosis with axillary lymph node metastasis in breast carcinoma is uncommon. Observation: We report a case of a patient aged 59 years presenting a painless nodule in the right bre...Introduction: The coexistence of tuberculosis with axillary lymph node metastasis in breast carcinoma is uncommon. Observation: We report a case of a patient aged 59 years presenting a painless nodule in the right breast for one year. The scan and mammography revealed a long-axis node of 3 × 2 × 1 cm in the upper outer quadrant of the right breast ranked stage IV by the American College of Radiology (ACR), associated with a set of axillary lymph nodes and the largest one measuring 15 × 15 × 20 millimeters (mm). The breast biopsy helped diagnose a Scarff Bloom Richardson (SBR) grade II non-specific invasive carcinoma, modified by Ellis and Elston. A right mastectomy associated with a lymph node dissection was performed. We noticed a not well defined and whitish 5 mm tumor mass associated with 16 lymph nodes removed. The histological examination confirmed the diagnosis of SBR grade II non-specific invasive carcinoma with invasion of 7 lymph nodes (N+ = 7/16). In 3 metastatic lymph nodes, there were epithelioid and gigantocellular granulomas with full central necrosis. The Ziehl Neelsen staining had highlighted acid-fast bacilli. The tumor was oestrogen and progesteron receptor, without an overexpression of the oncoprotein human epidermal growth factor receptor 2 (HER2), which corresponds to a 0 score and the Ki 67 proliferation index assessed at 10%. The patient was given an anti-tuberculosis treatment combining Rifampicin (H), Isoniazid (I), Pyrazinamid (Z), Ethambutol (E) over 2 months and secondly a combination of Rifampicin and Isoniazid over 4 months (2RHZE/4 RH). The anti-tumor chemotherapy used a protocol combining 3 FAC60+ 3 Docetaxel (F = Fluorouracil®A = Adriblastin®, C = Cyclophosphamid). Conclusion: This coexistence is uncommon, of incidental discovery and necessitates a multidisciplinary care.展开更多
目的了解男男性接触者(men who have sex with men,MSM)不安全性行为状况及其影响因素,为开展有针对性的干预工作提供建议。方法通过滚雪球的方式招募MSM进行面对面的问卷调查。以不安全性行为为应变量,人口学特征、艾滋病防治知识知晓...目的了解男男性接触者(men who have sex with men,MSM)不安全性行为状况及其影响因素,为开展有针对性的干预工作提供建议。方法通过滚雪球的方式招募MSM进行面对面的问卷调查。以不安全性行为为应变量,人口学特征、艾滋病防治知识知晓水平、性行为状况、接受干预服务等为自变量进行逐步向前法的logistic回归分析与不安全性行为的因素。结果调查的1 044名MSM中,艾滋病防治知识知晓率高(89.5%),近6个月与男性发生无保护性的肛交比例为63.8%。多因素回归分析发现,在婚、文化程度低、干部职员、待业人员、艾滋病防治知识认知水平差、过去1年未接受干预服务是影响不安全性行为的独立危险因素。结论无保护性性行为的发生将促进艾滋病在MSM人群中的传播,开展有针对性的干预和扩大干预工作的覆盖面是当前MSM人群艾滋病防治工作的重点。展开更多
文摘Introduction: The coexistence of tuberculosis with axillary lymph node metastasis in breast carcinoma is uncommon. Observation: We report a case of a patient aged 59 years presenting a painless nodule in the right breast for one year. The scan and mammography revealed a long-axis node of 3 × 2 × 1 cm in the upper outer quadrant of the right breast ranked stage IV by the American College of Radiology (ACR), associated with a set of axillary lymph nodes and the largest one measuring 15 × 15 × 20 millimeters (mm). The breast biopsy helped diagnose a Scarff Bloom Richardson (SBR) grade II non-specific invasive carcinoma, modified by Ellis and Elston. A right mastectomy associated with a lymph node dissection was performed. We noticed a not well defined and whitish 5 mm tumor mass associated with 16 lymph nodes removed. The histological examination confirmed the diagnosis of SBR grade II non-specific invasive carcinoma with invasion of 7 lymph nodes (N+ = 7/16). In 3 metastatic lymph nodes, there were epithelioid and gigantocellular granulomas with full central necrosis. The Ziehl Neelsen staining had highlighted acid-fast bacilli. The tumor was oestrogen and progesteron receptor, without an overexpression of the oncoprotein human epidermal growth factor receptor 2 (HER2), which corresponds to a 0 score and the Ki 67 proliferation index assessed at 10%. The patient was given an anti-tuberculosis treatment combining Rifampicin (H), Isoniazid (I), Pyrazinamid (Z), Ethambutol (E) over 2 months and secondly a combination of Rifampicin and Isoniazid over 4 months (2RHZE/4 RH). The anti-tumor chemotherapy used a protocol combining 3 FAC60+ 3 Docetaxel (F = Fluorouracil®A = Adriblastin®, C = Cyclophosphamid). Conclusion: This coexistence is uncommon, of incidental discovery and necessitates a multidisciplinary care.
文摘目的了解男男性接触者(men who have sex with men,MSM)不安全性行为状况及其影响因素,为开展有针对性的干预工作提供建议。方法通过滚雪球的方式招募MSM进行面对面的问卷调查。以不安全性行为为应变量,人口学特征、艾滋病防治知识知晓水平、性行为状况、接受干预服务等为自变量进行逐步向前法的logistic回归分析与不安全性行为的因素。结果调查的1 044名MSM中,艾滋病防治知识知晓率高(89.5%),近6个月与男性发生无保护性的肛交比例为63.8%。多因素回归分析发现,在婚、文化程度低、干部职员、待业人员、艾滋病防治知识认知水平差、过去1年未接受干预服务是影响不安全性行为的独立危险因素。结论无保护性性行为的发生将促进艾滋病在MSM人群中的传播,开展有针对性的干预和扩大干预工作的覆盖面是当前MSM人群艾滋病防治工作的重点。
