Chronic granulomatous mastitis

Presentation

Patient with a history of palpable lesion in the left breast for 2 years.

Patient Data

Age: 40 years
Gender: Female

Left breast

Ultrasound

Observing a mass located in the lower internal quadrant which is of irregular morphology, lobulated margin, heterogeneous with a mixed component (cystic and solid), parallel to the cutaneous plane, with a central vascular map after the application of color Doppler.

Additionally, a left axillary lymph node is observed at level I, which retains its reniform shape, with cortical thickening of 3.8 mm (type II) preserving central fatty hilum, measuring 10 mm in short axis.

Pathology

Incisional biopsy was performed, with the result of Chronic granulomatous mastitis.

Case Discussion

According to Pluguez-Turull et al, idiopathic granulomatous mastitis is a rare benign inflammatory breast entity characterized by lobulocentric granulomas.

It usually has a recurrent or prolonged natural disease course, usually affects parous premenopausal women, and frequently is clinically associated with hyperprolactinemia.

Ultrasound shows a large irregular hypoechoic parallel mass with tubular extensions.

The main differential diagnoses for iiopathic granulomatous mastitis is malignancy, the most important is inflammatory breast cancer. Ultrasound-guided needle aspiration may be helpful initially for distinguishing an inflammatory breast process from a malignancy.

In this case, an incisional biopsy was performed with the result of chronic granulomatous mastitis.

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