Presentation
Previous delivery - 3 yrs back. C/o I & D for right breast abscess - in August 2013 Incisional scar at 3 o'clock, about 2 -3 cm away from nipple. C/o discharge from scar. High WBC count.
Patient Data
Incisional scar is noted at 3 o'clock, about 2 -3 cm away from nipple. Depth of scar is about 15 mm. Prominent ducts are noted extending from scar to nipple.
Dilated ducts with echoes ( about 10 - 12 mm diameter ) in 8 to 10 o'clock. Braching is noted on peripheral aspect. Length is about 30 - 35 mm. They communicate with nipple.
Few small dilated ducts ( 4 -5 mm diameter ) are noted at 6 o'clock and 2 o'clock. They appear to reach to nipple or scar.
Rest of the breast shows normal glandular parenchyma .
There is no focal solid mass lesion noted.
Pectoralis muscle is normal.
There are about 3 ovoid, non-necrotic nodes with preserved hilar fat and vascularity in right axilla.
Case Discussion
Surgery - abscess.
Histopathology - granulomatous disease.
Ziehl Neelsen (Acid Fast ) staining - positive, suggesting tuberculosis.