Multiple breast abscesses
Updates to Case Attributes
The above described MRI and sonographic findings are consistent with breast abscesses.
The differential diagnosesdiagnosis of other rim-enhancing breast lesions onMRI:
invasive
Ductal Carcinomaductal carcinoma (IDC):Nonnon-otherwisespecified( NOS(NOS).seroma
ruptured or
Inflamed Cystinflamed cystinvasive or intracysticpapillary carcinoma
The abscessAbscess versus infiltrating ductal carcinoma:
the abscess shows prolonged slow intenseenhancement, slow washout (plateau or type II time-intensity curve) with non-enhancingcentral fluid collection. This is in contrary to the DIC with rapid intenserim-enhancement and delayed centripetal enhancement which is highly specific
.hyperintense on T2WI and STIR. The highly cellular carcinomawith
packed cellularityis usually T2 isointense to hypointense.the abscess is most often near the nipple
,and is tender,palpable and may have erythema. Associated oedema on T2WI. Mayseehave associatedskin thickening (> 2;2 mm).in equivocal cases: US-guided aspiration/drainage.Follow-up after appropriate antibiotic course may be tried
.
-<p><strong>The above described MRI and sonographic findings are consistent with <a href="/articles/breast-abscess" title="Breast abscess">breast abscess</a>. </strong></p><p>The differential diagnoses of other rim-enhancing <a href="/articles/breast-mri-enhancement-curves" title="MRI enhancement pattern on breast lesions">breast lesions</a> on-MRI:</p>--<p></p><ul>-<li>invasive Ductal Carcinoma (IDC): Non-otherwise-specified( NOS).</li>-<li>medullary Carcinoma</li>-<li>seroma</li>-<li>ruptured or Inflamed Cyst</li>-<li>granulomatous mastitis</li>-<li><a href="/articles/fibrocystic-change-of-the-breast" title="Fibrocystic changes" style="line-height: 1.5;">fibrocystic changes</a></li>-<li>invasive or intracystic papillary carcinoma</li>-<li><a href="/articles/malignant-phyllodes-tumour" title="Malignant phyllodes tumors" style="line-height: 1.5;">phyllodes tumour</a></li>-<li><a href="/articles/angiosarcoma-of-breast" title="Breast angiosarcoma" style="line-height: 1.5;">angiosarcoma</a></li>-</ul><p>The abscess versus infiltrating ductal carcinoma : </p>--<p></p><ul>-<li>the abscess shows prolonged slow intense-enhancement, slow washout (plateau or type II time-intensity curve) with non-enhancing-central fluid collection. This is in contrary to the DIC with rapid intense-rim-enhancement and delayed centripetal enhancement which is highly specific.</li>-<li>hyperintense on T2WI and STIR. The carcinoma-with packed cellularity is usually T2 isointense to hypointense.</li>-<li>the abscess is most often near nipple, tender,-palpable and may have erythema. Associated oedema on T2WI. May see associated-skin thickening (> 2 mm).</li>-<li>in equivocal cases: US-guided aspiration/drainage.-Follow-up after appropriate antibiotic course may be tried.</li>- +<p>The above described MRI and sonographic findings are consistent with <a href="/articles/breast-abscess" title="Breast abscess">breast abscess</a>es. </p><p>The differential diagnosis of other rim-enhancing <a href="/articles/breast-mri-enhancement-curves" title="MRI enhancement pattern on breast lesions">breast lesions</a> on MRI:</p><ul>
- +<li><p><a href="/articles/invasive-ductal-carcinoma" title="Invasive ductal carcinoma">invasive ductal carcinoma</a> (IDC): non-otherwise specified (NOS).</p></li>
- +<li><p><a href="/articles/medullary-carcinoma-of-the-breast" title="Medullary carcinoma of the breast">medullary carcinoma</a></p></li>
- +<li><p>seroma</p></li>
- +<li><p>ruptured or inflamed cyst</p></li>
- +<li><p><a href="/articles/granulomatous-mastitis" title="Granulomatous mastitis">granulomatous mastitis</a></p></li>
- +<li><p><a href="/articles/fibrocystic-change-breast" title="Fibrocystic changes">fibrocystic changes</a></p></li>
- +<li><p>invasive or <a href="/articles/intracystic-papillary-carcinoma-breast" title="Intracystic papillary carcinoma (breast)">intracystic</a> <a href="/articles/papillary-carcinoma-of-the-breast" title="Papillary carcinoma of the breast">papillary carcinoma</a></p></li>
- +<li><p><a href="/articles/malignant-phyllodes-tumour" title="Malignant phyllodes tumors">phyllodes tumour</a></p></li>
- +<li><p><a href="/articles/angiosarcoma-of-breast" title="Breast angiosarcoma">angiosarcoma</a></p></li>
- +</ul><p>Abscess versus infiltrating ductal carcinoma:</p><ul>
- +<li><p>the abscess shows prolonged slow intense enhancement, slow washout (plateau or type II time-intensity curve) with non-enhancing central fluid collection. This is in contrary to the DIC with rapid intense rim-enhancement and delayed centripetal enhancement which is highly specific</p></li>
- +<li><p>hyperintense on T2WI and STIR. The highly cellular carcinoma with is usually T2 isointense to hypointense</p></li>
- +<li><p>the abscess is most often near the nipple and is tender, palpable and may have erythema. Associated oedema on T2WI. May have associated skin thickening (>2 mm)</p></li>
- +<li><p>in equivocal cases: US-guided aspiration/drainage. Follow-up after appropriate antibiotic course may be tried</p></li>
References changed:
- 1. Trop I, Dugas A, David J et-al. Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 2011;31 (6): 1683-99. <a href="http://dx.doi.org/10.1148/rg.316115521">doi:10.1148/rg.316115521</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/21997989">Pubmed citation</a><span class="auto"></span>
- 2. Iglesias A, Arias M, Santiago P et-al. Benign breast lesions that simulate malignancy: magnetic resonance imaging with radiologic-pathologic correlation. Curr Probl Diagn Radiol. 2007;36 (2): 66-82. <a href="http://dx.doi.org/10.1067/j.cpradiol.2006.12.001">doi:10.1067/j.cpradiol.2006.12.001</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/17331838">Pubmed citation</a><span class="auto"></span>
- Trop I, Dugas A, David J et-al. Breast abscesses: evidence-based algorithms for diagnosis, management, and follow-up. Radiographics. 2011;31 (6): 1683-99. <a href="http://dx.doi.org/10.1148/rg.316115521">doi:10.1148/rg.316115521</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/21997989">Pubmed citation</a><span class="auto"></span>
- Iglesias A, Arias M, Santiago P et-al. Benign breast lesions that simulate malignancy: magnetic resonance imaging with radiologic-pathologic correlation. Curr Probl Diagn Radiol. 2007;36 (2): 66-82. <a href="http://dx.doi.org/10.1067/j.cpradiol.2006.12.001">doi:10.1067/j.cpradiol.2006.12.001</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/17331838">Pubmed citation</a><span class="auto"></span>
Updates to Link Attributes
Updates to Primarylink Attributes
Updates to Study Attributes
multiple irregular andmarginally enhancing thick-walled cystic lesions
are seenwithin the upper inner andouter quadrants as well as retro-areolar and lower central portion of the left breast; the largest isseenat the left upper inner quadrant at 10 o'clockposition measuring 3Xx 2.5 cm as well as at the left upper outer quadrant at 1o'clock . All these marginally-enhancing cystic lesionsare seen demonstratingdemonstrate low T1 and high STIR signal as well as predominately high T2 signal with somecystic lesionsare seen withhaving intermediate T2 signal, denoting variableproteinaciousproteinaceous components.associated parenchymal thickeningand enhancement as well as mild diffuse skin thickening with enhancement
.dynamic contrast-enhanced MRI ofthe breasts shows type II time intensity curves with rapid rise followed byplateau
.normal entire right breast
.bilateral non-specific axillarylymph nodes