DOCSLIB.ORG

Plasma Cell Mastitis In

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Plasma Cell Mastitis In in vivo 30 : 727-732 (2016) doi:10.21873/invivo.10987 Review Plasma Cell Mastitis in Men: A Single-center Experience and Review of the Literature ANDREA PALMIERI 1, VALERIO D’ORAZI 2, GIOVANNI MARTINO 1, FEDERICO FRUSONE 1, DANIELE CROCETTI 3, MARIA IDA AMABILE 1 and MARCO MONTI 4 1Department of Surgical Sciences, 3Pietro Valdoni Department of Surgery, and 4Department of Gynecological, Obstetrics and Urologic Sciences, Sapienza University of Rome, Rome, Italy; 2Department of General Microsurgery and Hand Surgery, Fabia Mater Hospital, Rome, Italy Abstract. Plasma cell mastitis is an inflammatory disease of in men was documented in 1974 by Tedeschi and Mc Carthy the breast parenchyma, rare in males. In the last 40 years, few (9). Our recent observation and treatment of male patients cases have been described in literature. Our recent treatment affected by plasma cell mastitis raised a series of diagnostic, of male patients affected by plasma cell mastitis raised a series etiological and therapeutic issues persuading us to carry out of issues which led us to carry out a critical review of the a critical review of the literature. literature. Plasma cell mastitis is often not well defined and is difficult to assess by clinical examination and radiological Our Single-center Experience investigation alone. An understanding of the pathogenesis and the mechanisms behind plasma cell mastitis may help improve Out of a total of 411 breast surgeries performed between the diagnostic and therapeutic course of the disease, leading 2011 and 2015 at the Department of Surgical Sciences, to a more targeted and less invasive treatment. Sapienza University of Rome, Italy, we recorded six cases of breast surgeries in men (1.46% of the total). In three cases Plasma cell mastitis is an inflammatory disease of the breast out of these six (0.73% of the total), the final histological parenchyma, frequent in females, characterized by a diagnosis was gynecomastia, in one case it was ductal periductal phlogistic reaction, accompanied by ductal ectasia. carcinoma, and in two cases (0.48% of the total) the final It was described for the first time by Burkitt in 1850 (1). In histological diagnosis was plasma cell mastitis. the literature, this disease is also known as granulomatous The first case of plasma cell mastitis concerned a 56-year- mastitis, obstructing mastitis, comedo mastitis (2), periductal old man who complained of the appearance of a hard mastitis (3, 4), and mammary duct ectasia (5-7). Plasma cell retroareolar lump, with smooth edges, which was quite mastitis is more frequent in young women and in women painful, and without nipple secretions. A bilateral breast who have not had pregnancy nor breastfed (8). It is ultrasound examination was performed which showed a solid, characterized by occasional mastodynia with ductal ectasia non-homogeneous lesion, with irregular edges and diameter and usually presents as a retroareolar lump with inverted of 17 mm (Figure 1). An ultrasound-assisted core biopsy was nipple and secretions. The most common complication is the performed due to suspicion of a neoplastic lesion, with the onset of a fistula (7). The first case of plasma cell mastitis aim of characterizing the lesion. The histological examination revealed intense chronic inflammation, mostly plasmacellular, and focal steatonecrosis, without neoplastic cells. Therefore, the patient did not undergo surgery. An appropriate anti- Τhis article is freely accessible online. inflammatory therapy was performed and the patient healed in about 3 weeks. At further follow-up evaluation, no signs Correspondence to: Maria Ida Amabile, MD, Ph.D., Department of of breast disease were observed, as previously described (10). Surgical Sciences Sapienza University of Rome, Viale Regina Elena The second case concerned an otherwise healthy 76-year- 324, 00161 Rome, Italy. Tel/Fax: +39 0649972449, e-mail: [email protected] old man who reported the presence of a hard retroareolar lump, which was quite painful, without nipple secretions. The Key Words: Plasma cell mastitis, male breast, periductal phlogistic breast ultrasound examination showed a hypoechoic lesion reaction, review. with poorly defined edges and perilesional/ intralesional 0258-851X/2016 $2.00+.40 727 in vivo 30 : 727-732 (2016) Figure 1. Ultrasound examination of the left breast revealing the presence of a retroareolar solid lump with a diameter of approximately 17 mm. vascularization. Ultrasound-assisted fine-needle aspiration of the terminal ducts (12). In 1984, Chan and Lau described cytology obtained hematic material which was not useful in the case of a patient who had a breast lump treated with diagnosis. The patient refused any other invasive excision of the nodule (13), and in 1985 Ashworth et al. investigations and an excisional open biopsy was performed presented a similar case, but treated with excision of the major by periareolar access, without the need to position a metallic ducts (14). In 1996, Downs and Fisher described two cases of guide wire, as it is necessary instead in cases of female breast breast lumps in human immunodeficiency virus-positive lesions with similar dimensions and characteristics (11). Entire patients, the first treated with excisional biopsy, while the excision of the lump was carried out. The postoperative second with antibiotic therapy (15). In 2001, Al-Masad definitive histological examination documented a diagnosis of documented two cases treated with excisional biopsy, one of plasma cell mastitis. No further therapies were necessary. which was concomitant with Behçet's disease, suggesting that In both cases, further investigations were accomplished in some cases of plasma cell mastitis are a sign of an underlying order to exclude plasma cell mastitis as being an epiphenomenon autoimmune disease (16). In 2005, Reddy et al. described the of an unknown autoimmune disease. The immunological profile case of a man with a retroareolar breast lump who underwent was within the normal range in both cases. a fine-needle aspiration and, subsequently, an excisional biopsy (17). In 2011, Gupta et al. treated a man with a breast Review of the Literature lump, which was initially thought to be a lobular carcinoma, after cytological examination by means of fine-needle Plasma cell mastitis is a disease relatively common in aspiration, and therefore treated with a simple mastectomy women, but quite rare in men. This is probably why between (18). The definitive histological examination, however, 1974 and 2016, only 14 cases have been described in the showed the presence of plasma cell mastitis, as in all of the literature, as can be seen in Table I. previous cases. In the case dating back to 2012, described by The first case of plasma cell mastitis described in a man Kim et al. , a documented retroareolar breast lump in a 37- dates back to 1974, and referred to a 57-year-old man with a year-old man was hypothesized to be breast carcinoma (19). lump of the left breast, who underwent a simple mastectomy The patient underwent mammography, breast ultrasound, and (9). In 1979, Mansel and Morgan documented three cases of subsequently an ultrasound-guided biopsy, the histological plasma cell mastitis (12). In the first, a breast lump with examination of which gave a diagnosis of plasma cell mastitis. inverted nipple and secretion was treated with an attempt at drainage and, subsequently, with a total ductectomy. In the Discussion second case, the patient had recurrent abscesses of the right breast that were treated initially with a ductectomy, and then It is difficult to differentiate between plasma cell mastitis, with a simple mastectomy (12). In the third case, a breast described for the first time during the last century (1) and lump was treated with subcutaneous mastectomy and excision later better defined by Bloodgood in 1921 (20) and by 728 Palmieri et al : Plasma Cell Mastitis in Men (Review) Table I. Literature review and patient characteristics. Author (Ref) Cases Patient Diagnostic Histology Therapy procedure Tedeschi and Mc Case 1 57-Year-old Excisional Chronic inflammatory infiltrate; Simple mastectomy Carthy (1 case) (9) man with left biopsy lymphocytes and plasma cells with breast lump desquamation of the duct epithelium Mansel and Morgan Case 2 62-Year-old man Mammography, Bilateral chronic inflammatory Bilateral drainage of (3 cases) (12) with left breast biopsy, infiltrate with abscess evolution the breast abscess with nodule, inverted microbial total ductectomy nipples and cultural discontinuous examination of secretion the secretion Case 3 47-Year-old man Cytological Chronic inflammatory infiltrate with Drainage of the abscess, with recurrent examination of marked focal granulomatous reaction total duct excision, right breast nipple secretion, repeated incisions and abscesses biopsy drainage, simple mastectomy Case 4 52-Year-old man Cytological Chronic inflammatory infiltrate Subcutaneous mastectomy with left examination of nipple with terminal duct excision breast lump secretion, biopsy Chan and Lau Case 5 34-Year-old man Biopsy Inflammatory infiltrate with Excision of the nodule (1 case) (13) with right lymphocytes and plasma cells breast lump Ashworth et al. Case 6 50-Year-old man Mammography, Inflammatory infiltrate with Excision of the major ducts (1 case) (14) with right biopsy lymphocytes and plasma cells breast lump Downs et al. Case 7 30-Year-old Fine-needle Mostly plasmacellular chronic Excisional biopsy (2 cases) (15) HIV-positive man aspiration
Load more

Recommended publications
  • Breast Infection: a Review of Diagnosis and Management Practices
    Review Eur J Breast Health 2018; 14: 136-143 DOI: 10.5152/ejbh.2018.3871 Breast Infection: A Review of Diagnosis and Management Practices Eve Boakes1 , Amy Woods2 , Natalie Johnson1 , Naim Kadoglou1 1Department of General Surgery, London North West Healthcare NHS Trust, Northwick Park Hospital, Middlesex, Londan 2Department of Medicine, Croydon University Hospital, Croydon, London ABSTRACT Mastitis is a common condition that predominates during the puerperium. Breast abscesses are less common, however when they do develop, delays in specialist referral may occur due to lack of clear protocols. In secondary care abscesses can be diagnosed by ultrasound scan and in the past the management has been dependent on the receiving surgeon. Management options include aspiration under local anesthetic or more invasive incision and drainage (I&D). Over recent years the availability of bedside/clinic based ultrasound scan has made diagnosis easier and minimally invasive procedures have become the cornerstone of breast abscess management. We review the diagnosis and management of breast infection in the primary and secondary care setting, highlighting the importance of early referral for severe infection/breast abscesses. As a clear guideline on the manage- ment of breast infection is lacking, this review provides useful guidance for those who rarely see breast infection to help avoid long-term morbidity. Keywords: Mastitis, abscess, infection, lactation Cite this article as: Boakes E, Woods A, Johnson N, Kadoglou. Breast Infection: A Review of Diagnosis and Management Practices. Eur J Breast Health 2018; 14: 136-143. Introduction Mastitis is a relatively common breast condition; it can affect patients at any time but predominates in women during the breast-feeding period (1).
    [Show full text]
  • Multiple Nodules of Pseudoangiomatous Stromal Hyperplasia (PASH) in a Menacme Patient: a Case Report
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Cadernos Espinosanos (E-Journal) Rev Med (São Paulo). 2017;96(Suppl. 1):1-35. Awards of the XXXVI COMU 2017. Multiple nodules of Pseudoangiomatous Stromal Hyperplasia (PASH) in a menacme patient: a case report Academic authors: Matheus Belloni Torsani Academic advisors: Gabriela Boufelli de Freitas, Edmund Chada Baracat, José Roberto Filassi, Sergio Masili-Oku Introduction: Pseudoangiomatous Stromal Hyperplasia (PASH) is a rare benign proliferating breast condition. It was first described in 1986 and less than 200 cases have been described ever since in the English literature. In the majority of cases, PASH is an incidental histological finding, but it can also be found in the physical examination as one typical single nodule (palpable, circumscribed, non-hemorrhagic), mostly on pre-menopausal women. It is frequently misdiagnosed as a fibroadenoma. PASH’s etiology remains unclear, although it is related to different benign breast entities. Objectives: This report aims to describe a case of multiple PASH nodules in a 31-year-old woman, its diagnosis and management. Case report: VSS, female, 31 years old, previously healthy, presented with increased right breast volume (swelling) for the last six months. She denied local pain and fever at the spot. When examined, right breast was bigger than the left one and showed discrete hyperemia. There were neither palpable nodules on the breasts nor axillary lymph nodes. The attending physician ruled the diagnosis as mastitis and prescribed clyndamicin for 7 days. He also ordered an ultrasound for complementary information. The exam result (ACR BI-RADS: 2) showed swelling, simple cysts (the biggest one measured 1.2 cm) and confirmed the diagnostic hypothesis for the right breast.
    [Show full text]
  • The Topic of the Lesson “Mastitis and Breast Abscess.”
    The topic of the lesson “Mastitis and breast abscess.” According to the evidence-based data from UpToDate extracted March of 19, 2020 Provide a conspectus in a format of .ppt (.pptx) presentation of not less than 50 slides containing information on: 1. Classification 2. Etiology 3. Pathogenesis 4. Diagnostic 5. Differential diagnostic 6. Treatment With 10 (ten) multiple answer questions. Lactational mastitis - UpToDate Official reprint from UpToDate® www.uptodate.com ©2020 UpToDate, Inc. and/or its affiliates. All Rights Reserved. Print Options Print | Back Text References Graphics Lactational mastitis Contributor Disclosures Author: J Michael Dixon, MD Section Editors: Anees B Chagpar, MD, MSc, MA, MPH, MBA, FACS, FRCS(C), Daniel J Sexton, MD Deputy Editors: Meg Sullivan, MD, Kristen Eckler, MD, FACOG All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Feb 2020. | This topic last updated: Jan 15, 2020. INTRODUCTION Lactational mastitis is a condition in which a woman's breast becomes painful, swollen, and red; it is most common in the first three months of breastfeeding. Initially, engorgement occurs because of poor milk drainage, probably related to nipple trauma with resultant swelling and compression of one or more milk ducts. If symptoms persist beyond 12 to 24 hours, the condition of infective lactational mastitis develops (since breast milk contains bacteria); this is characterized by pain, redness, fever, and malaise [1]. Issues related to lactational mastitis will be reviewed here. Issues related to other breast infections are discussed separately. (See "Nonlactational mastitis in adults" and "Primary breast abscess" and "Breast cellulitis and other skin disorders of the breast".) EPIDEMIOLOGY Lactational mastitis has been estimated to occur in 2 to 10 percent of breastfeeding women [2].
    [Show full text]
  • Study of Benign Breast Lumps in Females
    Original Research Article Study of benign breast lumps in females Kanchan Waikole1*, Mahendra Wante2 1,2Assistant Professor Department of General Surgery, Yashwantrao Chavan Memorial Hospital Pimpri Pune, Maharashtra, INDIA. Email: [email protected] , [email protected] Abstract Background: The need for study is to analyze the spectrum of benign breast disease with respect to age, sex, mode of presentation, clinical features and management. Methods: The study was conducted among 100 patients who were diagnosed to have various forms of Breast Diseases that are found to be benign in nature and admitted at YCMH, Pimpri from April 2017 to march 2019. Diagnosis was made by doing careful clinical assessment, ultrasonography and/or mammography, FNAC and specimen biopsy. Surgery was done as per indications. The conservative treatment was advocated based on clinical acumen, symptoms and supportive histology. The incidence of variable benign breast diseases and clinical features were compared and evaluated. Results: Out of the 100 patients who presented with breast lumps, fibroadenoma, accounted for 62 % of the cases, which was the highest number of patients. Fibroadenosis accounted 26 % of the cases. Inflammatory lesions like Fibrocystic changes, chronic abscess and granulomatous mastitis accounted 12%. Most patients presented with complaints of lump in the breast, pain or a combination of both. 45 patients had a right sided lesion and 35 had left side lesion. Bilateral disease was present in 20 patients. The upper outer quadrant was more involved and lower medial quadrants were least commonly affected. Of 62 cases of fibroadenoma, all were operated upon by excision.14 patients with Fibroadenosis had undergone excision where the diagnosis was doubtful.5 out of 8 patients with gralunamatous mastitis were subjected for wide local excision.
    [Show full text]
  • Idiopathic Granulomatous Lobular Mastitis in a Male Breast: a Case Report
    Archive of SID BREAST IMAGING Iran J Radiol. 2018 July; 15(3):e55996. doi: 10.5812/iranjradiol.55996. Published online 2018 June 11. Case Report Idiopathic Granulomatous Lobular Mastitis in a Male Breast: A Case Report Leehi Joo,1 Soo Hyun Yeo,1,* and Sun Young Kwon2 1Department of Radiology, Dong-San Medical Center, Keimyung University College of Medicine, Daegu, Korea 2Department of Pathology, Dong-San Medical Center, Keimyung University College of Medicine, Daegu, Korea *Corresponding author: Soo Huyn Yeo, Department of Radiology, Dong-San Medical Center, Keimyung University College of Medicine, 56 Dalseung-Ro, Jung-Gu, Daegu, 41931, Korea. Tel: +82-532507770, Fax: +82-532507766, E-mail: [email protected] Received 2017 June 23; Revised 2017 November 29; Accepted 2018 January 14. Abstract Idiopathic granulomatous lobular mastitis (IGLM) that mimics breast cancer both clinically and radiologically is a chronic inflam- matory condition of the breast without a known etiology. It usually affects childbearing women and is associated with pregnancy, lactation, or use of oral contraceptives. IGLM in a male breast is extremely rare, and only two case reports have been published. A 60-year-old man was referred to our hospital for right breast mass. He had right breast pain with a small palpable lump for 2 weeks. Ultrasonography (US) was performed with color Doppler US and US elastography. The lesion was diagnosed as IGLM pathologically by 14 gauge core needle biopsy. We describe a very rare case of IGLM arising from a male breast based on ultrasonographic and pathologic findings. IGLM should be considered as a differential diagnosis in male breast diseases, although the imaging findings may not be comparable with typical IGLM.
    [Show full text]
  • Idiopathic Granulomatous Mastitis
    CASE REPORT Idiopathic Granulomatous Mastitis Karyn Haitz, MD; Amy Ly, MD; Gideon Smith, MD, PhD that hyperprolactinemia2 or an immune response to local PRACTICE POINTS lobular secretions might play a role in pathogenesis. Early • Idiopathic granulomatous mastitis (IGM) is a painful misdiagnosis as bacterial mastitis is common, prompting and scarring rare granulomatous breast disorder that multiple antibiotic regimens. When antibiotics fail, patients can have a prolonged time to diagnosis that delays are worked up for inflammatory breast cancer, given the proper treatment. nonhealing breast nodules. Mammography, ultrasonog- • The pathogenesis of IGM remains poorly understood. raphy, and fine-needle aspiration often are unable to rule The temporal association of the disorder with breast- out carcinoma, warranting excisional biopsies of nodules. feeding suggests that hyperprolactinemia or an immune The patient is then referred to rheumatology for potential response to local lobular secretions might play a role. sarcoidosis or to dermatology for IGM. In either case, the • Although many cases of IGM resolve without treat- workup should be similar, but additional history focused ment, more severe cases can persist for a long on behavior and medications is essential in suspected IGM, period before adequate symptomatic treatment is copy given the association with hyperprolactinemia. provided with methotrexate, corticosteroids, or surgi- Because IGM is rare, there are no randomized, cal excision. placebo-controlled trials of treatment efficacy. In many • Before any of these therapies are applied, however, contributing factors, such as long-term breastfeeding cases,not patients undergo complete mastectomy, which and drugs that induce hyperprolactinemia, should be is curative but may be psychologically and physically identified and withdrawn.
    [Show full text]
  • Kjr-12-113.Pdf
    Pictorial Essay DOI: 10.3348/kjr.2011.12.1.113 pISSN 1229-6929 · eISSN 2005-8330 Korean J Radiol 2011;12(1):113-121 Diffuse Infi ltrative Lesion of the Breast: Clinical and Radiologic Features Yeong Yi An, MD1, Sung Hun Kim, MD1, Eun Suk Cha, MD2, Hyeon Sook Kim, MD3, Bong Joo Kang, MD1, Chang Suk Park, MD4, Na Young Jung, MD5, In Yong Whang, MD6, Soo Kyung Yoon, MD1 Departments of Radiology, 1Seoul St. Mary’s Hospital, Seoul 137-701, Korea; 2Ewha Womans University Mokdong Hospital, Seoul 158-701, Korea; 3St. Paul’s Hospital, Seoul 130-709, Korea; 4Incheon St. Mary’s Hospital, Incheon 403-720, Korea; 5Bucheon St. Mary’s Hospital, Bucheon 420- 717, Korea; 6Uijongbu St. Mary’s Hospital, Uijongbu 480-130, Korea The purpose of this paper is to show the clinical and radiologic features of a variety of diffuse, infi ltrative breast lesions, as well to review the relevant literature. Radiologists must be familiar with the various conditions that can diffusely involve the breast, including normal physiologic changes, benign disease and malignant neoplasm. Index terms: Breast; Breast ultrasonography or mammography; Magnetic resonance imaging INTRODUCTION this article, we discuss and illustrate a spectrum of diffuse infi ltrative breast lesions that range from normal physiologic The breast can be diffusely affected by a variety of changes to pathologic conditions. specifi c and unique disorders, including benign disorders that are closely related to physiologic changes and PHYSIOLOGIC CHANGES DURING LACTATION infl ammatory and infectious diseases, as well as by benign and malignant tumors. The clinical manifestations include During pregnancy and lactation, the breast undergoes unilateral or bilateral breast enlargement with/without a considerable changes in response to increased levels of palpable masses, shrinkage and breast asymmetry.
    [Show full text]
  • Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players
    Journal of Clinical Medicine Review Mastitis in Autoimmune Diseases: Review of the Literature, Diagnostic Pathway, and Pathophysiological Key Players Radjiv Goulabchand 1,2,3,4, Assia Hafidi 3,5, Philippe Van de Perre 6, Ingrid Millet 3,7, Alexandre Thibault Jacques Maria 1,3,4 , Jacques Morel 3,8 , Alain Le Quellec 1,3, Hélène Perrochia 3,5 and Philippe Guilpain 1,3,4,* 1 St Eloi Hospital, Department of Internal Medicine and Multi-Organic Diseases, Local Referral Center for Systemic and Autoimmune Diseases, 80 Avenue Augustin Fliche, F-34295 Montpellier, France; [email protected] (R.G.); [email protected] (A.T.J.M.); [email protected] (A.L.Q.) 2 Internal Medicine Department, Caremeau University Hospital, 30029 Nimes, France 3 Montpellier School of Medicine, University of Montpellier, 34967 Montpellier, France; a-hafi[email protected] (A.H.); [email protected] (I.M.); [email protected] (J.M.); [email protected] (H.P.) 4 Inserm U1183, Institute for Regenerative Medicine and Biotherapy, St Eloi Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier, France 5 Gui de Chauliac Hospital, Pathology Department, 80 Avenue Augustin Fliche, 34295 Montpellier, France 6 Pathogenesis and Control of Chronic Infections, Univ Montpellier, INSERM, EFS, Montpellier University Hospital, 34394 Montpellier, France; [email protected] 7 Lapeyronie Hospital, Montpellier University, Medical Imaging Department, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier, France 8 Department of Rheumatology, CHU and University of Montpellier, 34295 Montpellier, France * Correspondence: [email protected]; Tel.: +33-467-337332 Received: 8 February 2020; Accepted: 25 March 2020; Published: 30 March 2020 Abstract: Mastitis frequently affects women of childbearing age.
    [Show full text]
  • Bilateral Idiopathic Granulomatous Mastitis: a Case Report
    Case Report Bilateral Idiopathic Granulomatous Mastitis: A Case Report Abstract Idiopathic granulomatous mastitis is a rare, chronic inflammatory disease of the breast that frequently occurs in young women of childbearing age. The lesion usually presents as a unilateral firm breast mass with signs of inflammation but bilateral involvement has been reported. As the clinical presentation and radiological imaging of idiopathic granulomatous mastitis can mimic two common breast diseases, mastitis with abscess and breast cancer, a tissue biopsy is required for histopatho- logical diagnosis. The etiology and ideal treatment remain unclear. Conservative treatment with immunosuppressive therapy has proven good efficacy. In this case report, we present a patient diagnosed with bilateral idiopathic granulomatous mastitis. We review and discuss the clinical presentation, imaging, diagnosis and management of this patient that eventually responds well to steroid therapy. Likhitmaskul T, MD diopathic granulomatous mastitis is a relatively rare chronic inflammatory breast disease often mistaken for more common breast disorders, breast abscess or infectious mastitis, and can Tapanutt Likhitmaskul, MD1,2 mimic inflammatory breast cancer.1,2 Since it was first described in 2 I Rupporn Sukpanich, MD 3 2 1972 by Kessler and Wolloch , there have been only 541 cases reported Shinawatt Visutdiphat, MD 4 3 worldwide as shown in a 2011 review article. Most patients are Wichai Vassanasiri, MD women of reproductive age, most commonly aged 22 - 42.5 It frequently occurs two to six years after pregnancy.6 The lesion typically presents as a unilateral firm breast mass and can occur in Keywords: granulomatous mastitis, idiopathic, bilateral, steroid therapy any quadrants of the breast except in the subareolar area, sometimes with inflammation of overlying skin, abscesses and fistulae.7-10 It usually poses a complex diagnostic and therapeutic dilemma because of the unknown etiology.
    [Show full text]
  • Idiopathic Granulomatous Lobular Mastitis in a Male Breast: a Case Report
    BREAST IMAGING Iran J Radiol. 2018 July; 15(3):e55996. doi: 10.5812/iranjradiol.55996. Published online 2018 June 11. Case Report Idiopathic Granulomatous Lobular Mastitis in a Male Breast: A Case Report Leehi Joo,1 Soo Hyun Yeo,1,* and Sun Young Kwon2 1Department of Radiology, Dong-San Medical Center, Keimyung University College of Medicine, Daegu, Korea 2Department of Pathology, Dong-San Medical Center, Keimyung University College of Medicine, Daegu, Korea *Corresponding author: Soo Huyn Yeo, Department of Radiology, Dong-San Medical Center, Keimyung University College of Medicine, 56 Dalseung-Ro, Jung-Gu, Daegu, 41931, Korea. Tel: +82-532507770, Fax: +82-532507766, E-mail: [email protected] Received 2017 June 23; Revised 2017 November 29; Accepted 2018 January 14. Abstract Idiopathic granulomatous lobular mastitis (IGLM) that mimics breast cancer both clinically and radiologically is a chronic inflam- matory condition of the breast without a known etiology. It usually affects childbearing women and is associated with pregnancy, lactation, or use of oral contraceptives. IGLM in a male breast is extremely rare, and only two case reports have been published. A 60-year-old man was referred to our hospital for right breast mass. He had right breast pain with a small palpable lump for 2 weeks. Ultrasonography (US) was performed with color Doppler US and US elastography. The lesion was diagnosed as IGLM pathologically by 14 gauge core needle biopsy. We describe a very rare case of IGLM arising from a male breast based on ultrasonographic and pathologic findings. IGLM should be considered as a differential diagnosis in male breast diseases, although the imaging findings may not be comparable with typical IGLM.
    [Show full text]
  • Granulomatous Mastitis and Sarcoidosis Differential Diagnosis: a Case Report
    Summer 2019, Volume 4, Issue 3 Case Report Journal Homepage: http://crcp.tums.ac.ir Granulomatous Mastitis and Sarcoidosis Differential Diagnosis: A Case Report Sepehr Sahraiyan , Mahsa Abbaszadeh* , Nasim Khajavi Rad, Sahar Karimpour Reyhan, Ali Afshari Department of Internal Medicine, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Use your device to scan Citation Sahraiyan S, Abbaszadeh M, Khajavi Rad N, Karimpour Reyhan S, Afshari A. Granulomatous Mastitis and Sarcoidosis- Dif and read the article online : ferential Diagnosis: A Case Report. Case Reports in Clinical Practice .2019; 4(3):64-68. Running Title: Granulomatous Mastitis and Sarcoidosis Differential Diagnosis A B S T R A C T Granulomatous mastitis is a pathological diagnosis with a variety of causes, and its treatment Article info: depends on the underlying cause. We report a case of granulomatous mastitis in a 25-year-old Received: 24 June 2019 woman admitted with erythema nodosum and an unresponded acute inflammatory mastitis Revised: 31 July 2019 to treatment. It was challenging for us to make a definite diagnosis between sarcoidosis and idiopathic lobular granulomatous mastitis for her. In the end, our diagnosis was sarcoidosis 17 August 2019 Accepted: because of dactylitis we found in her physical examination which responded dramatically to nonsteroidal anti-inflammatory drug treatment. We started therapy with corticosteroids and Keywords: immunosuppressant drugs and offered her continuous follow-up. Sarcoidosis; Granulomatous mastitis; Breast; Erythema nodosum Introduction diseases like sarcoidosis, tuberculosis, and vasculitis, to name but a few. In the clinical presentation, it can be ranulomatous mastitis is a pathological -di easily confused with other conditions like breast cancer, agnosis in which the breast biopsy shows non-granulomatous infection, and trauma.
    [Show full text]
  • A Case Report and Review of Literature
    Case Report Open Access DOI: 10.19187/abc.20174132-36 Synchronous Idiopathic Granulomatosis Mastitis and Breast Cancer: A Case Report and Review of Literature Ahmad Kaviania,b, Sanaz Zand*b, Mojgan Karbakhshc, Farid Azmoudeh Ardaland a Department of Surgery, Tehran University of Medical Sciences, Tehran, Iran b Kaviani Breast Disease Institute, Tehran, Iran c Department of Community and Preventive Medicine, Tehran University of Medical Sciences, Tehran, Iran d Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran ARTICLE INFO ABSTRACT Received: Background: Idiopathic granulomatous mastitis (IGM) is a rare benign breast 13 February 2017 disease, which can mimic breast cancer. As the managements of IGM and breast Revised: cancer are entirely different and the initial clinical manifestations are similar in 19 February 2017 Accepted: several cases, it is very important to differentiate them. 25 February 2017 Case presentation: We reported a 48-year-old female patient with IGM and breast cancer. She was referred to the outpatient clinic with bilateral large masses and clinical impression of bilateral breast cancer with inflammatory features in the right side. Through pathology, the diagnoses of invasive ductal carcinoma (IDC) for the left breast lesion and IGM for the right breast lesion were confirmed, respectively. Incisional biopsy was performed for the right breast lesion to rule out breast cancer and to make sure of the diagnosis of IGM. Keywords: Conclusion: To the best of our knowledge, breast cancer and IGM were Breast cancer, reported only in two studies. Although IGM is not the underlying cause of breast inflammatory disease, idiopathic granulomatosis malignancy, the diagnosis of breast cancer should always be kept in mind.
    [Show full text]