1,488 results on '"granulomatous mastitis"'
Search Results
202. Granulomatous mastitis in a 50-year-old male: A case report and review of literature.
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Cui LY, Sun CP, Li YY, and Liu S
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Background: Granulomatous mastitis (GM) an inflammatory disease of the breast that usually affects women of childbearing age, occurs very rarely in males., Case Summary: We present a case study of a 50-year-old male patient with GM. The patient developed a breast lump following the cleaning of a previously embedded dirt-filled nipple. While an initial improvement was noted with antibiotic therapy, a recurrence occurred a year later, showing resistance to the previously effective antibiotics. Subsequently, the lesion was excised. The histopathological examination confirmed the diagnosis of GM., Conclusion: GM should be considered a possible diagnosis of male breast masses., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)
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- 2024
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203. Investigation of multi-infections and breast disease comorbidities in granulomatous mastitis.
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Esmaeil NK and Salih AM
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Introduction: Granulomatous mastitis (GM) is an inflammatory breast disease typically caused by infection, posing diagnostic challenges. It can coexist with other breast disorders or multiple infections, which have been vaguely discussed. This study investigates the incidence of multi-infection and breast disease comorbidities in GM., Method: The study enroled 63 females who had a confirmed diagnosis of GM. Laboratory investigations and bacterial cultures had been conducted for all the cases. The patients had undergone ultrasonography examination utilizing the LOGIQ E9 system. Core needle biopsy had been done to procure tissue samples for histopathological examination. Thorough scrutiny and assessment of patients' records were performed. The variables encompassed age at presentation, breastfeeding data, parity, smoking status, seasonal affliction, hair-washing agents, exposure to radiation, comorbidities, and clinical, ultrasound and histopathological findings., Results: The patients' ages ranged from 24 to 50. Breastfeeding history was positive in nearly all cases (97%). The majority of cases exhibited multiparity (81%). In total, 63.5% were passive smokers. Multi-infections were detected in six cases (9.5%). Among them, B. cepacia complex and Toxoplasma gondii were identified in two cases (3.16%). Other multi-infections involved Staphylococcus epidermidis and Toxoplasma gondii , Burkholderia cepacia and S. kloosii and Toxoplasma gondii , Staphylococcus epidermis and Brucella spp., Candida spp. and Brucella spp. Histopathological analysis revealed GM comorbidities with other breast diseases in 35% of the cases., Conclusion: Multi-infections and breast disease comorbidities may further complicate diagnosis and management of GM. The findings of this study may raise additional questions about the nature of the disease or potential complications associated with it., Competing Interests: There are no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
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- 2024
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204. Granulomatous mastitis: A diagnostic challenge-3 year single institutional experience.
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Khan AA, Ahuja S, Zaheer S, Ahluwalia C, Singh M, Kolte S, and Ranga S
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- Female, Humans, Retrospective Studies, Breast pathology, Granuloma diagnosis, Granuloma pathology, Biopsy, Fine-Needle, Necrosis pathology, Granulomatous Mastitis diagnosis, Granulomatous Mastitis pathology
- Abstract
Background: Granulomatous mastitis (GM) is often clinico-radiologically misdiagnosed as breast malignancy. Tuberculosis, foreign body reactions, fungal and parastic infections, and autoimmune diseases can cause GM. The present study aimed to assess the spectrum of GM on fine-needle aspiration biopsy (FNAB) smears along with its histopathological and clinico-radiological findings., Materials and Methods: It was a retrospective study which included all cases of GM diagnosed on FNAB over a period of 3 years. The histopathological diagnosis was retrieved, wherever possible. All the FNA smears and histopathological sections were reviewed for the presence of epithelioid granulomas, necrosis, epithelioid histiocytes, inflammatory cells including plasma cells, neutrophils, eosinophils, multinucleated giant cells, and epithelial component and associated atypia, if any. The inflammatory cells and multinucleated giant cells were graded on a scale of 0 to 3+ in every case., Results: Among the 22 cases evaluated, the most common inflammatory infiltrate was lymphocyte followed by neutrophils and eosinophils. Caseous necrosis was appreciated in 7 (31.8%) cases, out of which 5 (22.7%) were diagnosed as tubercular mastitis on FNA smears. Ziehl Neelson stain was done in all FNAB smears and AFB was positive in 7 (31.8%) cases. Histopathological correlation was available for 14 cases (63.6%). The most common diagnosis on histopathology was idiopathic GM having lobulo-centric granulomatous inflammation, epithelioid histiocytes, neutrophils, and lymphocytes., Conclusion: FNAB is a reliable and minimally invasive tool to diagnose tubercular mastitis, idiopathic GM and also ruling out clinicoradiological suspicion of malignancy. Careful examination of cytological smears can prevent an unnecessary biopsy in granulomatous lesions of breast., (© 2023 Wiley Periodicals LLC.)
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- 2024
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205. Treatment of Granulomatous Mastitis With Steroids: Should the Decision to End the Treatment be Made Radiologically?
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Çetin K, Sıkar HE, Feratoğlu F, Taşdoğan B, and Güllüoğlu BM
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Objective: Idiopathic granulomatous mastitis (IGM) is a benign inflammatory breast disease of unknown etiology that affects women in their reproductive period. The most commonly preferred option as first-line treatment is steroids, but the lack of a standard treatment protocol and high recurrence rate after treatment constitutes a recurring challenge during its management. The aim of this study was to investigate whether the decision to end the treatment should be made radiologically or clinically., Materials and Methods: This retrospective cohort study included IGM patients who had complete clinical recovery with steroids and were followed for a minimum of 30 months. Patient demographics, disease severity and findings, treatment regimens and duration, and magnetic resonance imaging (MRI) findings at clinical recovery were assessed for their relation to recurrence., Results: Eighty-nine patients who were clinically completely healed after steroid treatment for IGM were included in the study. At the time of clinical healing, 51 (57.3%) patients had a complete radiological response and 38 (42.7%) had a partial radiological response (PRR) on MRI. Overall, recurrence developed in 22 (24.7%) patients after a median 38.6-month follow-up. Patients who experienced recurrence were significantly older and had PRR when their treatment was stopped upon clinical healing., Conclusion: During the process of clinical healing, the imaging findings revealed that the remaining disease seems to be a significant predictor for recurrence in IGM patients. In patients with PRR, extending the treatment with either prolonged steroid therapy or by surgical excision of the occult residual disease may prevent recurrences in IGM patients., Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare., (©Copyright 2024 by the Turkish Federation of Breast Diseases Societies / European Journal of Breast Health published by Galenos Publishing House.)
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- 2023
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206. Clindamycin: An Effective Treatment for Granulomatous Mastitis Caused by Corynebacterium Kroppenstedtii in a Pregnant Patient.
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Abdalla E, Elmudathir A, Ahmed AH, Ali B, Elhadi Ali M, Taha NM, and Khan FY
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Corynebacterium spp. are Gram-positive bacteria, and recent studies have proposed a potential link between granulomatous mastitis and Corynebacterium kroppenstedtii infections, posing a challenge in selecting appropriate antibiotics, particularly in pregnant women. A young pregnant woman presented with a palpable lump in her left breast. Subsequent assessment revealed the presence of necrotising granulomatous mastitis attributed to C. kroppenstedtii . Initially treated with amoxicillin/clavulanate, the patient showed no improvement. Consequently, clindamycin was administered based on culture and sensitivity results, which resulted in a favourable response with no recurrence of symptoms. This report aims to emphasise the efficacy of clindamycin as a treatment option for granulomatous mastitis caused by C. kroppenstedtii ., Learning Points: Alternative antibiotics for treatment of granulomatous mastitis can be effective.The safety and efficacy of antibiotics in pregnancy is important., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2024.)
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- 2023
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207. Idiopathic granulomatous mastitis: A systematic review of 3060 patients.
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Martinez‐Ramos, David, Simon‐Monterde, Laura, Suelves‐Piqueres, Consuelo, Queralt‐Martin, Raquel, Granel‐Villach, Laura, Laguna‐Sastre, Jose Manuel, Nicolau, Maria Jesus, and Escrig‐Sos, Javier
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ANTIBIOTICS , *TREATMENT of mastitis , *ADRENOCORTICAL hormones , *GRANULOMA , *SYSTEMATIC reviews , *THERAPEUTICS - Abstract
Idiopathic granulomatous mastitis is a rare benign breast disease. A systematic review was designed. Clinical and therapeutic characteristics were analyzed. Human Development Index (HDI) was used to define two groups of study: group A (very high and high HDI) and group B (medium and low HDI). Corticosteroid therapy was done in 69% group A and 78% group B. Surgery was done in 63% in group A and 83% in group B. Antibiotics were used in 68% group A and 88% group B. There is no consensus about optimal treatment for granulomatous mastitis. [ABSTRACT FROM AUTHOR]
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- 2019
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208. Surgical treatment of granulomatous mastitis: Our experience in Bahrain.
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Alrayes, Amal, Almarzooq, Raed, and Abdulla, Hussain Adnan
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BREAST cancer surgery , *CANCER relapse , *DEBRIDEMENT , *GRANULOMA , *PATIENT aftercare , *LONGITUDINAL method , *MASTITIS , *PUBLIC hospitals , *DECISION making in clinical medicine , *RETROSPECTIVE studies , *DUCTAL carcinoma - Abstract
Granulomatous mastitis (GM) is a rare, benign inflammatory disease of the breast with unknown etiology. There is no universally accepted treatment for GM. The aim of this study was to show our experience with surgical treatment of GM. A retrospective review was performed for 29 cases that were surgically treated at Salmaniya Medical Complex (SMC) in Bahrain between 2010 and 2017. All patients underwent surgical excision with debridement and removal of retroareolar ductal system. None of these patients experienced recurrence in the follow‐up period. Complete surgical excision of the whole inflammatory mass is the treatment of choice. [ABSTRACT FROM AUTHOR]
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- 2019
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209. Are all Granulomatous Mastitis Cases Tuberculous?: A Study on the Role of Cytology in Evaluation of Granulomatous Mastitis.
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AGARWAL, Charu, SINGH, Kanika, PUJANI, Mukta, RAYCHAUDHURI, Sujata, SHARMA, Nimisha, and CHAUHAN, Varsha
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MASTITIS , *BREAST cancer diagnosis , *CYTOLOGY , *NEEDLE biopsy , *ZIEHL-Neelsen stain , *POLYMERASE chain reaction - Abstract
Objective: Granulomatous mastitis is a rare inflammatory condition of the breast clinically mimicking breast carcinoma and pyogenic abscess, thereby creating a diagnostic dilemma. Tuberculous mastitis is a rare clinical entity accounting for approximately 3% of all mammary lesions. All cases of granulomatous mastitis diagnosed cytologically over a period of 3 years were evaluated to ascertain the cases with tuberculous etiology. Material and Method: Fine needle aspiration cytology of the breast lump was performed and all the cytological parameters were evaluated. Wherever histopathology was available, the diagnosis was confirmed on Hematoxylin & Eosin stained sections and the Ziehl Neelsen (ZN) stain was applied. Results: A total of 10 cases of granulomatous mastitis were diagnosed on cytology during the 3-year period. On cytological smears, four cases showed presence of ill-formed granulomas and one case had scattered epithelioid histiocytes; however, the rest of the cases had well-formed granulomas. Finally, four out of ten cases were labeled as tuberculous mastitis based on the ZN stain/Tuberculosis-Polymerase chain reaction (TB-PCR) and the other six cases were granulomatous mastitis. Conclusion: Cytology plays a significant role in the diagnosis of granulomatous mastitis. This study re-emphasizes the role of the cytopathologist in the accurate and early diagnosis of these lesions so that unnecessary surgery can be avoided, and also highlights the fact that all granulomatous mastitis cases are not tuberculous. [ABSTRACT FROM AUTHOR]
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- 2019
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210. Role of Bacteriological Agents in Idiopathic Granulomatous Mastitis: Real or Not?
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Kıvılcım, Taner, Altıntoprak, Fatih, Memiş, Bahar, Ferhatoğlu, Murat Ferhat, Kartal, Abdulcabbar, Dikicier, Enis, Ciftçi, İhsan Hakkı, and Dilek, Fatma Hüsniye
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MASTITIS , *ETIOLOGY of diseases , *BREAST biopsy , *BACTERIOLOGY , *MOLECULAR diagnosis of cancer - Abstract
Objective: Granulomatous mastitis is a rare, benign, chronic inflammatory disease of the breast of unknown etiology. This study evaluated bacteriologic agents that might play a role in the etiology of granulomatous mastitis using a molecular method with a universal primer after isolating deoxyribonucleic acid (DNA) from pathology specimens from patients diagnosed with granulomatous mastitis. Materials and Methods: Breast biopsy material in the pathology department obtained between July 2008 and June 2013 was analyzed. The history of the granulomatous mastitis patients was examined in detail and paraffin block sections of the biopsy material were used to determine the presence of bacteria with a universal DNA primer. Results: This study examined 45 granulomatous mastitis patients who had been diagnosed using excisional, incisional, or core biopsies. We evaluated multiple bacterial taxa, but obtained no positive result using a nucleic-acid-based assay with a universal primer. Conclusion: The etiology of idiopathic granulomatous mastitis remains unclear. Further studies with a large number of patients should aim to identify the causative agent. [ABSTRACT FROM AUTHOR]
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- 2019
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211. Mastitis granulomatosa asociada a eritema nudoso: estudio de 42 casos
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Francesca Mitjavila, Clàudia Llobera-Ris, María Jesús Pla, R.M. Penín, Carlos Moreno-Vílchez, and Joaquim Marcoval
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Gynecology ,medicine.medical_specialty ,business.industry ,Medicine ,General Medicine ,Granulomatous mastitis ,business ,Panniculitis ,medicine.disease - Abstract
Resumen Introduccion La mastitis granulomatosa (MG) se define por la presencia de inflamacion granulomatosa en el tejido mamario. El eritema nudoso (EN) es una paniculitis inflamatoria reactiva caracterizada por nodulos subcutaneos dolorosos en las extremidades inferiores. La asociacion entre MG y EN ha sido descrita, pero esta poco estudiada. Nuestro objetivo fue analizar las caracteristicas clinicas de las pacientes diagnosticadas de MG en nuestro centro y su asociacion con EN. Metodos Se revisaron retrospectivamente los casos diagnosticados histologicamente de MG entre 1995 y 2020. Resultados Cuarenta y dos mujeres fueron diagnosticadas de MG. La edad media al diagnostico fue de 41,619 anos y el 59,5% tenian ascendencia sudamericana. El EN se asocio con MG en el 11,9% de las pacientes. Las pacientes con EN fueron diagnosticadas precozmente respecto a aquellas con MG aislada (0,4 meses frente a 6,81; p Conclusion El EN en pacientes con GM puede facilitar el diagnostico precoz de esta rara condicion que imita el cancer de mama.
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- 2022
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212. Breast tuberculosis cases rising in Sicily.
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Strazzanti, Angela, Trovato, Claudio, Gangi, Santi, and Basile, Francesco
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Highlights • Mammary tuberculosis (TM) is an extremely rare condition. • The differential diagnosis between breast cancer and breast tuberculosis is very important. • It was possible to identify the Mycobacterium tuberculosis in between nucleic acid probes and PCR. Abstract Introduction Our work has been reported in line with the SCARE criteria [ 21 ]. Mammary tuberculosis (TM) is an extremely rare condition (Khanna et al., 2000 [ 1 ]). It has been estimated to be 0.1% of breast lesions examined histologically, but it reaches 3–4% in countries such as India and Africa where the disease shows a high incidence. This disease can present a diagnostic problem in radiological and microbiological investigations, and thus extreme caution is necessary. Presentation of case A 26 year-old Eritrean female with a personal history of HIV infection came to our Emergency Department showing generalized limphoadenopathy and weakness in addition to a huge right breast mass. Our examination revealed a tender mass measuring 12 × 10 cm that involved all right breast. Her skin was not erythematous and local temperature was normal. She was painless. Fine needle aspiration (FNA) showed a milky and greenish shaded fluid. Conclusions Nowadays the differential diagnosis between breast cancer and breast tuberculosis is very important, mostly in Italy and in particular in Sicily, where the massive influx of immigrants has compelled physicians to reconsider the presence of !tuberculosis. [ABSTRACT FROM AUTHOR]
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- 2018
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213. Granulomatous Mastitis: A Therapeutic and Diagnostic Challenge.
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Wolfrum, angelika, Kümmel, Sherko, Theuerkauf, Ingo, Pelz, Enrico, and Reinisch, Mattea
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MASTITIS diagnosis ,TREATMENT of mastitis ,ADRENOCORTICAL hormones ,ANTIBIOTICS ,BIOPSY ,MAMMOGRAMS ,CORYNEBACTERIUM diseases ,HISTOLOGICAL techniques ,HYPEREMIA ,IMMUNITY ,IMMUNOTHERAPY ,INFLAMMATION ,MAGNETIC resonance imaging ,MAMMAPLASTY ,MASTITIS ,PAIN ,RARE diseases ,ULTRASONIC imaging ,DISEASE management ,SYMPTOMS - Abstract
Granulomatous mastitis (GM) is a rare benign inflammatory breast disease that affects mostly women of childbearing age with a history of breastfeeding. The etiopathogenesis is still unknown; however, inflammation as the result of a reaction to trauma, metabolic or hormonal processes, autoimmunity, and an infection with Corynebacterium kroppenstedtii have all been implicated. Clinical findings are pain, mass, hyperemia, and inflammation. Because the clinical presentation can mimic infectious mastitis or inflammatory carcinoma, the disease course is often protracted. The diagnosis is made by histopathology. Biopsies show a granulomatous formation in combination with a localized infiltration of multi-nucleated giant cells, epithelioid histiocytes, and plasma cells. Ultrasound, mammography, and magnetic resonance imaging are not specific; however, ultrasound and mammography should be done to exclude other pathologies. Due to the lack of data including randomized controlled studies, the management of GM is controversial. In Western industrialized countries, most authors use a therapy regimen starting with antibiotics and corticosteroids, followed by continuous steroid therapy and surgery in patients with persisting symptoms. More data are needed to define the best therapy. The role of immunotherapy has not yet been ascertained. The implementation of a registry to collect more information on this rare disease is highly recommended. [ABSTRACT FROM AUTHOR]
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- 2018
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214. 中药内服联合外用治疗肉芽肿性乳腺炎肿块期临床疗效观察.
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刘丽辉, 侯小倩, 李秋华, and 马跃海
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- 2021
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215. Characterization and antimicrobial susceptibility of one antibiotic-sensitive and one multidrug-resistant Corynebacterium kroppenstedtii strain isolated from patients with granulomatous mastitis
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I. Fernández-Natal, D. Rodríguez-Lázaro, T. Marrodán-Ciordia, J.A. Sáez-Nieto, S. Valdezate, H. Rodríguez-Pollán, A. Tauch, and F. Soriano
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Antimicrobial susceptibility ,Corynebacterium kroppenstedtii ,granulomatous mastitis ,MALDI-TOF MS ,multidrug-resistant isolate ,Infectious and parasitic diseases ,RC109-216 - Abstract
Human infections associated with Corynebacterium kroppenstedtii are rarely reported, and this organism is usually described as antibiotic sensitive. Almost all published cases of C. kroppenstedtii infections have been associated with breast pathology in women and have been described in New Zealand, France, Canada, India and Japan. Here we describe the microbiologic characteristics of two strains isolated from two women diagnosed of granulomatous mastitis in Spain. One C. kroppenstedtii isolate was antibiotic sensitive while the other was multidrug resistant. Biochemical identification was possible using a wide battery of methods including API Coryne V2.0, API Strep, API NH, API NE, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA gene amplification and sequencing. Antimicrobial susceptibility to 28 antibiotics as determined by Etest showed one isolate being sensitive to benzylpenicillin, ciprofloxacin, moxifloxacin, gentamicin, vancomycin, clindamycin, tetracycline, linezolid and rifampin. The second isolate showed resistance to ciprofloxacin, moxifloxacin, clindamycin, tetracycline and rifampin. The multidrug-resistant isolate contained the erm(X), tet(W), cmx, aphA1-IAB, strAB and sul1 resistance genes known from the R plasmid pJA144188 of Corynebacterium resistens. These genes were absent in the genome of the antibiotic-sensitive isolate. This report confirms the tropism of this microorganism for women's breasts and presents the first description of a multidrug-resistant C. kroppenstedtii strain.
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- 2016
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216. Granulomatous Mastitis: A Rare Cause of Male Breast Lump
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Abdel Rahman A. Al Manasra and Mohammad F. Al-Hurani
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Granulomatous mastitis ,Male breast ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Mastitis is a common benign disorder of the female breast. It is frequently associated with tenderness, swelling and nipple discharge. We are describing an extremely rare case of an idiopathic granulomatous mastitis in the male breast. Only 1 previous case was reported. Case Report: A 29-year-old male patient presented with a hard, painless lump in the right breast of 2 weeks duration. The patient underwent surgical excision with margin. The histopathologic findings were consistent with granulomatous mastitis. The case was reported as idiopathic granulomatous mastitis after exclusion of all known causes of the disease. Conclusion: Granulomatous mastitis is rare in females and extremely rare in male breast tissue. Since this disease mimics breast cancer in its clinical picture and radiologic findings are usually not conclusive, surgical excision is recommended in all cases.
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- 2016
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217. A microbiological and clinical review on Corynebacterium kroppenstedtii
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Andreas Tauch, Isabel Fernández-Natal, and Francisco Soriano
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Corynebacterium kroppenstedtii ,Taxonomy ,Breast pathology ,Breast abscess ,Granulomatous mastitis ,Antimicrobial susceptibility ,Antibiotic resistance genes ,Infectious and parasitic diseases ,RC109-216 - Abstract
The genus Corynebacterium represents a taxon of Gram-positive bacteria with a high G + C content in the genomic DNA. Corynebacterium kroppenstedtii is an unusual member of this taxon as it lacks the characteristic mycolic acids in the cell envelope. Genome sequence analysis of the C. kroppenstedtii type strain has revealed a lipophilic (lipid-requiring) lifestyle and a remarkable repertoire of carbohydrate uptake and utilization systems. Clinical isolates of C. kroppenstedtii have been obtained almost exclusively from female patients and mainly from breast abscesses and cases of granulomatous mastitis. However, the role of C. kroppenstedtii in breast pathologies remains unclear. This review provides a comprehensive overview of the taxonomy, microbiology, and microbiological identification of C. kroppenstedtii, including polyphasic phenotypic approaches, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the use of 16S rRNA gene sequencing. A clinical review presents reported cases, various antimicrobial treatments, antibiotic susceptibility assays, and antibiotic resistance genes detected during genome sequencing. C. kroppenstedtii must be considered a potential opportunistic human pathogen and should be identified accurately in clinical laboratories.
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- 2016
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218. Bilateral idiopathic granulomatous mastitis
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Mehmet Velidedeoglu, Fahrettin Kilic, Birgul Mete, Mucahit Yemisen, Varol Celik, Ertugrul Gazioglu, Mehmet Ferahman, Resat Ozaras, Mehmet Halit Yilmaz, and Fatih Aydogan
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breast cancer ,cancer ,corticosteroids ,granulomatous mastitis ,idiopathic ,tuberculosis ,Surgery ,RD1-811 - Abstract
Objectives: Idiopathic granulomatous mastitis (IGM) is a benign rare inflammatory pseudotumor. Bilateral involvement of IGM has been reported in a few cases. To our knowledge, this study is the largest series of bilateral cases to date. The goals of this study were to present clinical features of bilateral IGM and to evaluate the results of treatments. Materials and methods: We performed a retrospective review of the idiopathic granulomatous mastitis database from 2010 to 2013. Ten female patients who met required histologic and clinical criteria of IGM in both breasts were included in study. Demographic data, clinical findings, medication history, and radiologic findings are presented. Results: The mean age at onset of the disease was 38.4 ± 8.3 years (range: 29–52 years). Nine patients had no recurrence during a mean follow-up period of 21 months (range: 11–26 months). Additionally, the median time to second breast involvement was 15.6 months. Conclusion: Bilateral IGMs have a higher rate of more relapse and greater resistance to medical therapies than do unilateral IGMs. Surgical management should be avoided unless all medical treatment options have been exhausted. Nevertheless, expectant management seems a rational option for the treatment of bilateral IGM.
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- 2016
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219. Idiopathic granulomatous mastitis and steroid use during the pandemic of COVID-19
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Hasan, Calis, Zulfikar, Karabulut, Yilmaz, Guler, and Serkan, Sengul
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Adult ,Cancer Research ,Oncology ,SARS-CoV-2 ,Prednisolone ,COVID-19 ,Humans ,Female ,Granulomatous Mastitis ,General Medicine ,Middle Aged ,Retrospective Studies - Abstract
BACKGROUND: Steroid therapy is an immunosuppressive treatment and may have possible side effects in a pandemic period. However, the number of studies on the use corticosteroids for the treatment of idiopathic Granulomatous Mastitis (IGM) especially during the pandemic is almost negligible. METHODS: The data of patients with the diagnosis of IGM between January–December 2020 in the General Surgery Clinic were retrospectively analyzed. The patients were explained in detail that steroid therapy is an immunosuppressive treatment and it may have possible side effects. Prednisolone 0.5–1 mg/kg/day was given as steroid therapy. The treatment was planned for 4–6 months according to the severity of the symptoms and was completed by reducing it to a total dose of 10 mg/month. RESULTS: Eleven patients were included in the study. Five patients had completed steroid treatment and continued their follow-up. In our study, a total of six patients were receiving steroid therapy. CONCLUSIONS: There is no consensus yet on the use of the steroid in the COVID-19 pandemic. Low doses Corticosteroids (
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- 2022
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220. Activation of C3 and C5 May Be Involved in the Inflammatory Progression of PCM and GM
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Xiao-qiang Li, Hong-guang Sun, Xiao-hong Wang, Hao-jie Zhang, Xiang-sheng Zhang, Yue Yu, Jian Liu, Qing-qun Guo, and Zhen-lin Yang
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Inflammation ,Immunology ,Humans ,Immunology and Allergy ,Female ,Granulomatous Mastitis ,Flow Cytometry ,Complement Activation - Abstract
Plasma cell mastitis (PCM) and granulomatous mastitis (GM) are the most common inflammatory diseases constituting nonbacterial mastitis (NBM). However, the pathogenesis of NBM remains unclear. In this study, risk factors for NBM were assessed, as well as the pathological features of PCM and GM. The levels of C3/C3a-C3aR and C5/C5a-C5aR1 of tissues were detected by IHC and WB. Exosomes were isolated from serum and identified by transmission electron microscopy. Then, C3 and C5 levels were detected in peripheral blood, and exosomes were assessed by flow cytometry and immunoelectron microscopy. Obesity and prolonged lactation were risk factors for NBM. The infiltration of plasma cells and lymphocytes around the dilated catheter in PCM and the formation of granulomatous structures in GM were the respective pathological features. C3/C3a-C3aR and C5/C5a-C5aR1 levels were elevated in PCM and GM tissue samples. There were no differences in peripheral blood levels of C3 and C5, while C3a and C5a were highly expressed in exosomes. These results suggest that the complement family is activated in PCM and GM, exosomes enrich C3a and C5a, and mediate the spread of inflammation. These findings provide new insights into the molecular mechanisms of PCM and GM and identify therapeutic targets.
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- 2022
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221. Breast cancer coexisting with granulomatous mastitis in a young woman
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Simei, Xie, Haijing, Yu, Hongyi, Gao, Zhenqiang, Lian, and Qi, Wang
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Diagnosis, Differential ,Humans ,Breast Neoplasms ,Female ,Granulomatous Mastitis ,General Medicine - Published
- 2022
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222. Inflammatory Lesions of the Breast
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Tse, Gary, Tan, Puay Hoon, Schmitt, Fernando, Tse, Gary, Tan, Puay Hoon, and Schmitt, Fernando
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- 2013
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223. Imaging in Inflammatory Carcinoma
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Villaseñor-Navarro, Yolanda, Aguilar-Cortazar, Lesvia Olivia, Perez-Zuñiga, Irma, Cruz-Morales, Roberto Alejandro, Pavon-Hernandez, Cecilia Magdalena, Perez-Badillo, Martha Patricia, Ignacio Garcia-Gomez, Jaime, de la Garza-Salazar, Jaime G., editor, Meneses-Garcia, Abelardo, editor, and Arce-Salinas, Claudia, editor
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- 2013
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224. Radiologic Features of Idiopathic Granulomatous Mastitis and Emphasis on Analysis of Socioeconomic Status: Over 5 Years of Experience
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Cüneyt Yücesoy, Ünsal Han, Nurdan Fidan, Betül Bozkurt, Zeynep Banu Aydın, Harun Karabacak, and Onder Eraslan
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Anamnesis ,medicine.medical_specialty ,business.industry ,Granulomatous mastitis ,Disease ,medicine.disease ,Dermatology ,Axillary Lymphadenopathy ,medicine ,Etiology ,Surgery ,Abscess ,business ,Body mass index ,Socioeconomic status - Abstract
The clinical and radiological findings of idiopathic granulomatous mastitis (IGM) can mimic breast carcinoma and several benign inflammatory breast diseases. The ultrasonographic (US) findings are important for the diagnosis. The purpose of our study was to discuss the radiological findings of idiopathic granulomatous mastitis and to analyze the socioeconomic status of patients to contribute to the etiology. A total of 93 patients with histopathological diagnosis of idiopathic granulomatous mastitis were included in the study. We recorded the radiological findings, the frequencies of involving quadrants, accompanying abscess, body mass index (BMI), breastfeeding history, number and age of children, and information indicating socioeconomic status such as monthly income, education level, and living area. Ultrasonography showed tubular hypoechoic masses in all breasts, cutaneous fistula in 50% breasts, abscess formation in 40.6%, and axillary lymphadenopathy in 40.6%. Doppler ultrasonography, mammography (MG), and magnetic resonance imaging (MRI) findings were nonspecific. According to the survey forms, 94.1% of the patients had moderate-low socioeconomic status; 80% of them lived in small towns, rural, or suburbs. Patients who had at least one child that is 6 years old or younger were 78.8% of all. As a result, the sonographic findings together with the information of anamnesis suggest us the diagnosis of idiopathic granulomatous mastitis. We particularly evaluated socioeconomic status. We think that low socioeconomic status may disrupt immunity as a stress factor and initiate idiopathic granulomatous mastitis due to the autoimmune background of the disease.
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- 2021
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225. Post-operative Ayurvedic management of non-healing idiopathic granulomatous mastitis - A case report
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Shibila K and Maya Balakrishnan
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medicine.medical_specialty ,Stanavidradhi ,business.industry ,medicine.drug_class ,Antibiotics ,RZ409.7-999 ,Context (language use) ,Granulomatous mastitis ,medicine.disease ,Dermatology ,BREAST ABSCESS ,Complementary and alternative medicine ,Dushta vrana ,Drug Discovery ,Case report ,medicine ,Histopathology ,Post operative ,Idiopathic granulomatous mastitis ,business ,Abscess ,Adverse effect ,Miscellaneous systems and treatments ,Breast abscess - Abstract
Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory disease of the breast which may present as painful, unilateral, discrete, breast masses with a tendency to recur. The pathogenesis is still unclear. In Ayurvedic literature, clinical features similar to IGM is seen in Stanavidradhi (breast abscess). We present the case of a 25-year old uniparous woman who had previously undergone excision biopsy for a breast lump and was diagnosed with IGM by histopathology examination. After one month, she developed pain, redness, and swelling at the operated site. She was treated for two months with corticosteroids and antibiotics, but the symptoms did not subside. After Ayurvedic treatment, the condition started to respond in a week and was completely resolved within three months. She was followed-up with medicines for three months and without medicines for another six months during which period, no recurrence was seen. The non-healing nature and high rate of recurrence of IGM necessitates prolonged treatment with steroids and antibiotics that have long-lasting adverse effects. In this context, Ayurveda may be able to offer an effective option with significantly fewer adverse effects, not only in the management of abscess and sinus, but also in prevention of recurrence.
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- 2021
226. Випадок лікування гранулематозного маститу
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V.Ye. Cheshuk
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medicine.medical_specialty ,business.industry ,Medicine ,Granulomatous mastitis ,business ,medicine.disease ,Dermatology - Abstract
Гранулематозний мастит — це хронічне запалення молочної залози. Розрізняють специфічний та ідіопатичний гранулематозний мастит. В статті наведено випадок ефективного лікування гранулематозного маститу антибіотиками та кортикостероїдами. Антибіотикотерапію призначали залежно від результатів бактеріологічних досліджень. Надано рекомендації щодо тактики лікування таких хворих.
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- 2021
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227. Infecciones mamarias por Corynebacterium kroppenstedtii: comunicación de 4 casos
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María Florencia Veiga, Nahuel Sanchez Eluchans, Marisa Almuzara, Carlos Vay, Rosana Cittadini, Ana María Ozuna Villca, Viviana Vilches, and Claudia Barberis
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Microbiology (medical) ,0303 health sciences ,030306 microbiology ,medicine.drug_class ,business.industry ,Sulfamethoxazole ,Antibiotics ,Clindamycin ,General Medicine ,Granulomatous mastitis ,medicine.disease ,Microbiology ,Trimethoprim ,Ciprofloxacin ,03 medical and health sciences ,medicine ,Ceftriaxone ,Vancomycin ,business ,medicine.drug - Abstract
Corynebacterium kroppenstedtii is an immobile, non-sporulated, glucose-fermenting and lipophilic gram-positive rod of the skin microbiota. In recent years, numerous isolates of this species have been reported mainly in breast infections, such as abscesses and granulomatous mastitis. We present here four cases of C. kroppenstedtii infections isolated from breast aspiration samples in women. C. kroppenstedtii was identified by conventional methodology and mass spectrometry (MALDI-TOF MS). Using the epsilometric method, these isolates showed susceptibility to penicillin, ceftriaxone, minocycline, ciprofloxacin, and vancomycin, and variable susceptibility to clindamycin and trimethoprim sulfamethoxazole. Due to the association of C. kroppenstedtii with mammary infections, the identification at the species level of those corynebacteria isolated from this location is highly advisable in order to reach the final diagnosis and to test the antimicrobial susceptibility in order to apply the appropriate antibiotic treatment.
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- 2021
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228. Granulomatous mastitis: An underdiagnosed inflammatory disease afflicting minority women
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Smith M. Ngeve, Sheryl G. Jordan, and Daniel R. Bacon
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Core needle ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Granulomatous mastitis ,Breast Imaging ,R895-920 ,Case Report ,Disparities ,Disease ,Corynebacterium ,medicine.disease ,Malignancy ,Dermatology ,Mastitis ,Medical physics. Medical radiology. Nuclear medicine ,Biopsy ,Ultrasound ,medicine ,Mammography ,Radiology, Nuclear Medicine and imaging ,Cystic Neutrophilic Granulomatous Mastitis ,business ,Abscess - Abstract
Granulomatous mastitis (GM) is an underdiagnosed and understudied benign inflammatory disease of the breast whose accurate diagnosis is confounded by mimicry of other breast pathologies (infectious mastitis and abscess, malignancy) and limited clinician knowledge of the disease. GM disproportionately affects minority women, furthering health disparities for a demographic already disadvantaged in the care of breast diseases. The first step in diagnosis is ultrasound followed by core needle biopsy yielding granulomatous inflammation. To far lesser degree, mammography, and MRI may play a role in narrowing the differential. A high index of clinical suspicion and multidisciplinary approach is required. The presence of Corynebacterium kroppensteddti may indicate one subtype of granulomatous mastitis called cystic neutrophilic granulomatous mastitis; disease stratification, and individualized therapy are on the horizon.
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- 2021
229. Xantho-granulomatous mastitis preceded by cysts on ultrasound: Two cases with review of literature
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Wendi Owen, Yuxi Zhang, Shadi Qasem, Margaret M. Szabunio, and Harit Kapoor
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medicine.medical_specialty ,Breast Neoplasms ,Mastitis ,Granulomatous mastitis ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Granulomatous Mastitis ,Stage (cooking) ,Ultrasonography ,Cysts ,business.industry ,Rare entity ,medicine.disease ,Dermatology ,Natural history ,Management implications ,030220 oncology & carcinogenesis ,Cyst formation ,Female ,business - Abstract
Xantho-granulomatous mastitis (XGM) is a rare entity, only recently described in 2005. These lesions are often biopsied due to their clinical and radiological resemblance to breast cancer. With limited clinical experience, the etiopathogenesis and natural history of XGM remains unknown. We present two cases of pathologically proven XGM that were imaged at two time-points, with the findings alluding to the possibility of a precursor stage of cyst formation. In addition, we present a thorough review of all cases published to date and discuss the differential considerations and management implications of XGM.
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- 2021
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230. Idiopathic granulomatous mastitis: introducing a diagnostic algorithm based on 5 years of follow-up of 152 cases from Turkey and a review of the literature
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Varol Celik, Birgul Mete, Engin Hatipoğlu, Tülin Öztürk, Ertugrul Gazioglu, Fahrettin Kilic, Veysel Umman, and Mehmet Velidedeoglu
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Pregnancy ,Turkey ,business.industry ,Medical record ,Mammary gland ,General Medicine ,Granulomatous mastitis ,Breast Disorder ,medicine.disease ,Single Center ,Breast cancer ,medicine.anatomical_structure ,medicine ,Etiology ,Humans ,Female ,Surgery ,Breast ,Granulomatous Mastitis ,business ,Algorithm ,Algorithms ,Follow-Up Studies - Abstract
The goals of this study were to report our clinical experience in a single center at a high-volume tertiary university hospital in Istanbul and to introduce a diagnostic algorithm based on a 5-year follow-up of 152 women with biopsy-proven idiopathic granulomatous mastitis (IGM). IGM is an uncommon, non-malignant, chronic inflammatory disease of the mammary gland with an unknown etiology. The symptoms, clinical presentation, and radiologic findings of IGM may resemble carcinomas. To our knowledge, this study comprises the largest series of IGM, especially with a 5-year follow-up, yet reported in the English literature. The present study reported our single-center clinical experience at a tertiary university hospital in Istanbul, Turkey, and introduced a diagnostic algorithm using our treatment protocol based on a 5-year follow-up of 152 women with biopsy-proven IGM. Our database of 10 years’ experience containing over 700 patients with IGM was evaluated. However, to assess recurrence and resistance to treatment, only the 152 patients with a long follow-up period of 5 years were included in the study group. The analysis included 152 women with biopsy-proven IGM who were treated between January 2009 and March 2014. The clinical data of the presentation, histopathology, and treatment modalities were analyzed by reviewing the medical records. Of the 152 patients diagnosed with granulomatous mastitis, 32 (21%) recovered by expectant management, while 14 (9%) responded to antibiotics, 65 (43%) received corticosteroids, 20 (13%) had antituberculosis medication, 16 (11%) underwent excision, and 5 (3%) responded to non-steroidal anti-inflammatory drugs. Fifty-one patients (33%) had recurrence; of these, 30 achieved a cure with second-line treatment, 16 underwent excision, and 5 achieved a cure with observation. IGM is a rare benign breast disorder, and clinicians need a high index of suspicion to diagnose it, as IGM can be mistaken for breast cancer. Unlike periductal mastitis, IGM does not evolve secondary to nicotine addiction and is typically seen in women of childbearing age with a recent history of pregnancy and lactation. The diagnosis can be challenging, and an evaluation with a multidisciplinary team is necessary. There is no consensus concerning the definitive treatment approach. We suggested a diagnostic algorithm in the present study, using our treatment protocol based on the 5 years’ follow-up of 152 women.
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- 2021
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231. Idiopathic granulomatous mastitis associated with erythema nodosum may indicate a worse prognosis
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Bilgul Mete, Berrin Papila Kundaktepe, Mehmet Velidedeoglu, and Serdal Ugurlu
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Adult ,medicine.medical_specialty ,Time Factors ,Cutaneous Fistula ,Fistula ,Inflammatory breast disease ,Granulomatous mastitis ,Gastroenterology ,Erythema Nodosum ,Rheumatology ,Recurrence ,Risk Factors ,Internal medicine ,medicine ,Humans ,Granulomatous Mastitis ,Retrospective Studies ,Erythema nodosum ,medicine.diagnostic_test ,business.industry ,medicine.disease ,Treatment Outcome ,Erythrocyte sedimentation rate ,Etiology ,Female ,business ,Breast feeding - Abstract
INTRODUCTION Idiopathic granulomatous mastitis (IGM) is a chronic inflammatory breast disease of unknown etiology, and erythema nodosum (EN) is a rare extramammary manifestation of this entity characterized by reddish, tender nodules of the lower legs. We aimed to investigate whether the association of IGM with EN has a role as a prognostic indicator. There are few case reports, and only 1 original article including 12 IGM patients with EN has been reported. METHODS We present 43 women with IGM coexisting with EN and 43 with a diagnosis of IGM only, who were randomly selected from 610 patients for a control group. To the best of our knowledge, this paper comprises the first comparative study of the coexistence of IGM and EN to be reported in the literature. RESULTS Our findings show that the association of IGM with EN indicates a more aggressive disease course. White blood cells, erythrocyte sedimentation rate, and C-reactive protein were significantly higher in the EN-positive group (P
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- 2021
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232. Detection of Corynebacterium kroppenstedtii in Granulomatous Lobular Mastitis Using Real-Time Polymerase Chain Reaction and Sanger Sequencing on Formalin-Fixed, Paraffin-Embedded Tissues
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Hongxin Fan, Alia Nazarullah, Preethi Dileep Menon, Kumari Vadlamudi, Daniel D. Mais, Hamza Tariq, and Srilakshmi Pandeswara
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Pathology ,medicine.medical_specialty ,Formalin fixed paraffin embedded ,Granulomatous mastitis ,Corynebacterium ,Biology ,Real-Time Polymerase Chain Reaction ,Pathology and Forensic Medicine ,law.invention ,symbols.namesake ,law ,Formaldehyde ,RNA, Ribosomal, 16S ,medicine ,Humans ,Granulomatous Mastitis ,Polymerase chain reaction ,Retrospective Studies ,Corynebacterium kroppenstedtii ,Sanger sequencing ,Paraffin Embedding ,Corynebacterium Infections ,General Medicine ,medicine.disease ,Abscess ,Medical Laboratory Technology ,Real-time polymerase chain reaction ,Granulomatous lobular mastitis ,Gram staining ,symbols ,Female ,human activities - Abstract
Context.— Associations between granulomatous lobular mastitis (GLM) and Corynebacterium kroppenstedtii have been reported since 2002, but large-scale studies to assess the actual prevalence of this bacterium in GLM have not been performed. Objective.— To assess the prevalence of C kroppenstedtii in GLM using real-time polymerase chain reaction and Sanger sequencing. Design.— We analyzed formalin-fixed, paraffin-embedded tissues from 67 cases of GLM by sequential DNA amplification and sequencing to assess the rate of C kroppenstedtii detection in GLM. A retrospective analysis including patient demographics, history of pregnancy and lactation, clinical signs and symptoms, radiographic findings, histologic pattern, Gram stain results, and microbial cultures was performed on 67 cases of GLM. In addition, 10 cases of nongranulomatous breast abscess were included as controls. Results.— C kroppenstedtii 16S rRNA SYBR real-time polymerase chain reaction was positive on formalin-fixed, paraffin-embedded tissues from 46 of 67 (68.7%) GLM cases, while all control cases were negative. Among the positive cases, the majority showed features of cystic neutrophilic granulomatous mastitis. Conclusions.— C kroppenstedtii was highly prevalent in GLM cases and was not found to be associated with nongranulomatous breast abscess in our study (P < .001).
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- 2021
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233. The effectiveness of methotrexate and low-dose steroid therapy in the treatment of idiopathic granulomatous mastitis
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Ömer Lütfi Akgül and Erkan Dalbaşı
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Adult ,medicine.medical_specialty ,Medicine (miscellaneous) ,Physical examination ,Granulomatous mastitis ,Malignancy ,Gastroenterology ,General Biochemistry, Genetics and Molecular Biology ,Pregnancy ,Internal medicine ,Internal Medicine ,medicine ,Carcinoma ,Humans ,Pharmacology (medical) ,Granulomatous Mastitis ,Prospective Studies ,Genetics (clinical) ,Retrospective Studies ,Anamnesis ,medicine.diagnostic_test ,business.industry ,Middle Aged ,Hepatitis B ,medicine.disease ,Methotrexate ,Methylprednisolone ,Reviews and References (medical) ,Female ,Steroids ,business ,medicine.drug - Abstract
BACKGROUND Idiopathic granulomatous mastitis (IGM) is a rare, chronic, benign, inflammatory breast disease of unknown cause. Patients usually present with a single breast mass, hyperemia, discharge, skin disorders, and fever. Radiological and clinical findings can mimic carcinoma and infection. OBJECTIVES To examine the treatment of IGM with methotrexate (MTX) + low-dose steroid, and present the results and follow-up data from our center. MATERIAL AND METHODS Sixty-two patients, diagnosed with IGM in our center between January 2009 and December 2017 were included in this study. Patients diagnosed with granulomatous mastitis histopathologically underwent testing with anamnesis, physical examination and imaging methods to exclude other diseases that cause granulomatous reactions. Patients with a history of malignancy, chronic infectious diseases such as hepatitis B and pregnant women were excluded from this study. Data collected from 62 patients were reviewed retrospectively for this study. RESULTS The mean patient age was 36.58 ±5.83 years (range: 28-54 years). Lesions were present in the right breast in 30 (48.38%) patients, the left breast in 26 (41.94%) patients and both breasts in 6 (9.68%) patients. Methotrexate was administered orally at a dose of 15 mg/week and methylprednisolone at a dose of 8 mg/day. The mean clinical and radiological remission periods of these patients were 10.14 ±1.21 months (range: 3-14 months). All patients attended regular follow-up appointments. The recovery rate of patients during follow-up was determined to be 93.71%. CONCLUSION Methotrexate + low-dose steroid therapy is successful in the treatment of IGM. Prospective, large case series and/or multi-center studies are needed to develop an IGM treatment algorithm.
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- 2021
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234. Pregnancy Associated Granulomatous Mastitis: Clinical Characteristics, Management, and Outcome
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Xin-Lin Lv, Ping Ning, Ying Xiong, Shun-Bo Li, Xiaorong Han, and Zeyu Liu
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Adult ,Pediatrics ,medicine.medical_specialty ,Breastfeeding ,Breast Neoplasms ,Mastitis ,Granulomatous mastitis ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,030225 pediatrics ,Maternity and Midwifery ,Humans ,Medicine ,Breast ,Granulomatous Mastitis ,Retrospective Studies ,Erythema nodosum ,030219 obstetrics & reproductive medicine ,Oligoarthritis ,business.industry ,Health Policy ,Infant ,Obstetrics and Gynecology ,Gestational age ,medicine.disease ,Breast Feeding ,Etiology ,Female ,business - Abstract
Background: We have already known that idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disorder that can clinically mimic breast carcinoma, especially affects parous women of childbearing age, but there is little literature to report about pregnancy associated granulomatous mastitis (PAGM). The aim of our study is to report and describe the clinical signs, managements, clinical course, and clinical outcomes after treatment of PAGM in our hospital. Methods: We retrospectively analyzed 15 pregnant patients who were diagnosed as PAGM in our hospital collected from December 2018 to December 2020 by reviewing medical records and questionnaire survey, including the patients' characteristics, clinical presentations, microbiological workups, tissue pathology, treatment modalities, outcomes, and follow-up data. Results: The mean age of these patients at diagnosis was 30.5 (range 24-35) years. All patients had one birth before, and had at least two gravida times, 6 of them (40%) had three gravida times, and only one of them had four gravida times at diagnosis. The mean weeks of gestational age were 23.7 (range 4-37) weeks. Two patients' BMI were greater than 30, which were considered obese. The mean time to presentation since last delivery was 38.4 (range 19-78) months. All patients had a history of breastfeeding; the average breastfeeding time was 12.97 months. Just 2 of them were diagnosed with lactational mastitis before. One patient smoked before, 1 patient had oral contraceptive pills before, 4 patients had breast trauma recently, 5 patients had positive bacterial culture of pyogenic fluids, 3 patients had nipple retraction, 6 patients had abnormal humoral immunity, shown as elevated C3 or C4, and 2 patients had elevated serum prolactin. All patients presented as a breast mass with pain; two of them had erythema nodosum and oligoarthritis. Nearly all patients had unilateral lesion. The mean follow-up was 11 (range 1-24) months. Thirteen patients gave birth to a healthy baby, and all babies had a healthy growth and development. Almost all patients chose observation during pregnancy. Nine patients demonstrated complete remission, five of them underwent surgery after steroids and/or antibiotics, one patient had observation alone, two chose postpartum steroids alone, and the last one chose postpartum antibiotics alone. The average time to complete remission was 11.2 (range 7-18) months. Conclusions: In general, PAGM is a much rare disorder which has onset during pregnancy, and mainly happens in the second trimester and the third trimester. PAGM patients were all parous women and generally within 5 years of their last pregnancy, also with uncertain etiology and pathogenesis. Observational therapy during pregnancy for PAGM is reliable and feasible.
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- 2021
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235. Negative pressure wound therapy of Corynebacterium jeikeium associated granulomatous mastitis.
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Maráz, Robert, Venczel, László, Sikorszki, László, Serfőző, Orsolya, Ambrózay, Éva, Patyi, Márta, and Cserni, Gábor
- Subjects
- *
ANTIBIOTICS , *ABSCESSES , *CORYNEBACTERIUM diseases , *DEBRIDEMENT , *MASTITIS , *NEGATIVE-pressure wound therapy - Abstract
We present the first Corynebacterium associated therapy resistant granulomatous mastitis successfully treated with negative pressure wound therapy (NPWT). Our patient had received five different courses of antibiotic therapy, and three surgical explorations before NPWT was introduced and resulted in healing. For a successful treatment, the use of targeted antibiotic therapy, steroid therapy and in case of progressive disease, wide excision is required. When this results in a large wound cavity, NPWT seems an effective and innovative option. [ABSTRACT FROM AUTHOR]
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- 2020
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236. Granulomatosis with polyangiitis with breast involvement mimicking metastatic cancer: Case report and literature review.
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Gadeyne, Laura, Henckaerts, Liesbet, Goffin, Karolien E., Gheysens, Olivier, Lerut, Evelyne, Roskams, Tania, Blockmans, Daniel, and Floris, Giuseppe
- Subjects
- *
GRANULOMATOSIS with polyangiitis , *METASTASIS , *POLYARTERITIS nodosa , *LITERATURE reviews , *BREAST biopsy , *THERAPEUTICS - Abstract
Granulomatosis with polyangiitis (GPA) is a systemic inflammatory disease, characterized by the presence of necrotizing vasculitis of small and medium-sized vessels, granulomatous inflammation and anti-neutrophil cytoplasmic antibodies (ANCAs). The diagnosis can be challenging due to the variable clinical presentation and possible involvement of virtually all organ systems. A correct diagnosis is indispensable for a timely start of medical treatment and to avoid unnecessary surgery. Therefore, cooperation with and the input of the pathologist is crucial. We report a case of a woman presenting with suspected metastatic cancer. The diagnosis of GPA was made mainly based on breast biopsy, and the patient was treated accordingly, with full recovery. This report provides a case description and a brief review of the literature. [ABSTRACT FROM AUTHOR]
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- 2020
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237. Breast tuberculosis: A case report of primary type mammary tuberculosis.
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Tazzioli, Giovanni, Macolino, Antonella, Combi, Francesca, Palma, Enza, Papi, Simona, Codeluppi, Mauro, and Mussini, Cristina
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- *
TUBERCULOSIS , *BREAST , *MASTITIS ,DEVELOPED countries - Abstract
Mammary tuberculosis is exceptional in developed countries. It can mimic an abscess or a granulomatous mastitis. In subjects coming from endemic areas, it is necessary to suspect a tuberculosis infection in case of recurrent mastitis refractory to antibiotics. Positivity of Quantiferon‐TB Gold assay can help to confirm the clinical suspicion. [ABSTRACT FROM AUTHOR]
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- 2019
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238. Spontaneous, idiopathic granulomatous mastitis in a pregnant patient: A case report and review of the literature.
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Liu G, McRitchie D, Russell E, and Cates EC
- Abstract
Idiopathic granulomatous mastitis is a rare breast condition of unclear etiology. Its course is often rapidly progressive, slow to resolve, and can have a high rate of recurrence. Clinical presentation can mimic breast abscess, infectious mastitis, and carcinoma of the breast, generating a diagnostic challenge. Histopathological analysis is required to make the diagnosis after common conditions are excluded. There is no standard treatment, however surgical excision, steroid treatment, and observation are commonly reported approaches. Here, we describe a complex case of a multiparous patient presenting with idiopathic granulomatous mastitis at 32 weeks gestation. In this review, we highlight the importance of collaboration amongst a multidisciplinary team for effective diagnosis and treatment. We discuss the use of oral corticosteroids in the antenatal period and illustrate the patient support required to both facilitate successful breastfeeding in the postpartum period and promote recovery., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)
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- 2023
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239. Cystic neutrophilic granulomatous mastitis: A case report and review of the literature.
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Gaskin D, Springer D, Latha K, Gaskin PS, and Reid A
- Abstract
The present study describes a case of cystic neutrophilic granulomatous mastitis. The clinical and radiological findings of the patient were consistent with idiopathic granulomatous mastitis. Cystic neutrophilic granulomatous mastitis is a rare subtype of mastitis with a distinct histological pattern that is associated with the Corynebacterium species. The diagnosis and treatment of cystic neutrophilic granulomatous mastitis remains a significant challenge due to the scarcity of available data. The present study describes a classic case of cystic neutrophilic granulomatous mastitis that includes clinical, radiological and histopathological findings. To the best of our knowledge, this is the first case documenting radiological findings before and after treatment. This report encourages the consideration of this entity in the differential diagnoses of mastitis., Competing Interests: The authors declare that they have no competing interests., (Copyright: © Gaskin et al.)
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- 2023
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240. Treatment of granulomatous lobular mastitis.
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Zhang Z and Zhao H
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- Female, Humans, Granulomatous Mastitis
- Abstract
Competing Interests: Declaration of competing interest All authors have no potential conflicts of interest to disclose.
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- 2023
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241. The efficacy of St John's wort oil macerates on intractable skin lesions of patients with idiopathic granulomatous mastitis: preliminary results
- Author
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Sema Yuksekdag
- Subjects
Adult ,Male ,Nursing (miscellaneous) ,Immunoglobulin M ,Plant Extracts ,Humans ,Plant Oils ,Fundamentals and skills ,Female ,Granulomatous Mastitis ,Hypericum ,Phytotherapy - Abstract
Objective: St John's wort (SJW, Hypericum perforatum) has a long history of medicinal use, mainly for its antidepressive effects and for wound healing. However, to the best of our knowledge, this is the first clinical study evaluating the effects of topical SJW oil macerates on the intractable skin lesions of idiopathic granulomatous mastitis (IGM). Method: SJW oil massage (twice daily for two minutes) was recommended between 2016 and 2019, only for patients with persistent or intractable skin lesions, after complete regression of granulomatous mass with two cycles of high-dose oral steroid and empiric antibiotics. Skin lesions were assessed and graded, before and after treatment, as clear, mild, moderate and severe. A questionnaire was also completed for each patient at the end of the six-week treatment. Results: A total of 21 patients with persistent IGM lesions used SJW oil after completion of the standard treatment protocol. All patients were women, and the mean age was 36.6 years. Hyperaemia (100%), scaling (61%), induration (52%) and ulcers (28%) were the predominant skin lesions. Distribution of the lesions according to the degree of severity were graded mild, moderate and severe, and seen in 35%, 41% and 23% of the patients, respectively. When compared with pre-treatment scores, there were very significant regressions (clear: 76.4%, mild: 17.6%, moderate: 3.9%, severe: 1.9%; pConclusion: SJW oil massage seems to be very effective in patients with IGM-related persistent skin lesions.
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- 2022
242. Benign Breast Disease: Periareolar Mastitis, Granulomatous Lobular Mastitis, and Lymphocytic or Diabetic Mastopathy
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Rachel E, Sargent and Stephen F, Sener
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Diabetes Mellitus ,Humans ,Female ,Granulomatous Mastitis ,Autoimmune Diseases - Abstract
Periareolar mastitis, granulomatous lobular mastitis, and lymphocytic or diabetic mastopathy are benign inflammatory breast conditions that require specialized knowledge of the pathophysiology to reduce the morbidity from surgical management.
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- 2022
243. Tuberculous mastitis: A masquerading face of granulomatous mastitis
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Eyüp Sabri Uçan, Aylin Özgen Alpaydın, Damla Gündüz Karayazı, Murat Kapkaç, Burça Takar, Osman Zekioğlu, Pınar Balcı, and Mehmet Rasih Yılmaz
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Pulmonary and Respiratory Medicine ,Adult ,Breast Tuberculosis ,Antitubercular Agents ,Lymphadenopathy ,Mastitis ,Critical Care and Intensive Care Medicine ,Diagnosis, Differential ,Young Adult ,Diagnosis ,Humans ,Tuberculosis ,Surgery ,tuberculosis mastitis ,Female ,breast abscess ,Granulomatous Mastitis ,Features ,Mammography - Abstract
Introduction: Tuberculosis (TB) mastitis is a rare form of granulomatous mas-titis. We aimed to evaluate the clinical characteristics and prognosis of patients diagnosed with TB mastitis.Materials and Methods: A descriptive study was carried out on patients who were reported to national tuberculosis control authorities as having TB masti-tis between 2003 and 2021. Demographic, histopathological, and radiological data including mammography, ultrasonography (US), and magnetic resonan-ce imaging (MRI) were reviewed. All were followed up to 24 months and prognosis was also evaluated.Results: This study identified 29 TB mastitis patients who had been diagnosed using excisional biopsies. The mean age was 33.5 +/- 10.1, all were premeno-pausal women. The most common symptom was breast mass (n= 24, %82.8), nearly half of the patients also had ipsilateral axillary lymphadenopathy (n= 14, 48.3). One-fourth of the patients had bilateral involvement (n= 7, 24.1%), and half of the patients (n= 16, 55.2%) presented with multiple masses. One patient had co-existing pulmonary TB. Predisposing factors for TB were not identified in any of the patients. Nearly half of the patients rece-ived prior mastitis treatment. The most common radiological finding was mass in both mammography and US. All patients received anti-tuberculosis treat-ment of a standard regimen for six to 21 months, three patients had a relapse but were finally cured.Conclusion: TB mastitis should be suspected in young and premenopausal women presenting with a breast mass and axillary lympha-denopathy in an endemic region. Radiological findings could not identify the diagnosis. A multidisciplinary approach including bacteriology and histopathology should be performed. Anti-tuberculosis treatment can be implemented successfully.
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- 2022
244. Granulomatous Mastitis: A Clinical Case in Pregnancy
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Mendes,Inês, Pinto,Catarina Gama, Rodrigues,Ana Cristina, Reis,Lídia, and Nunes,Filomena
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Granulomatous mastitis ,Pregnancy ,Breast carcinoma ,Corticotherapy - Abstract
A 38 weeks pregnant woman presents with lump in right breast associated with tenderness, heat and erythema for 1 month. After 2 antibiotic therapy regimens and abscess drainage without improvement, Trucut breast biopsy was performed, whose histological result was Granulomatous Mastitis. Medicated with high-dose, long-lasting corticosteroid therapy, there was improvement of the clinical condition. Idiopathic Granulomatous Mastitis is a rare entity that mimics breast cancer, whose etiology, incidence and treatment are yet to be defined. The knowledge of this disease leads to a timely diagnosis, avoiding unnecessary costs and improving the patient’s approach.
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- 2022
245. Granulomatous mastitis: etiology, imaging, pathology, treatment, and clinical findings.
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Barreto, David S., Sedgwick, Emily L., Nagi, Chandandeep S., and Benveniste, Ana P.
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Purpose: To outline the demographics, clinical presentation, imaging features, and treatment modalities observed among a series of patients diagnosed with biopsy-proven granulomatous mastitis (GM).Method: Following approval by institutional review board, retrospective chart review was performed on patients with biopsy-proven granulomatous mastitis at our institution in the period from January 2013 until October 2017.Results: A total of 90 patients were identified: 87 women and 3 men. The mean age was 35 years, mostly women in their reproductive age. In our study, patients with GM were more likely to be Hispanic compared to the general population. Sixty-three percent of patients were within 5 years of previous pregnancy. Painful palpable mass-like lesion was the most common physical finding. Breast ultrasound (US) was performed in all patients, and most commonly showed a hypoechoic irregular-shaped mass. Mammography (MG) showed asymmetry or irregular mass as the main finding. Definitive diagnosis was obtained by imaging-guided core needle biopsies in 94.4%. Conservative management was preferred, and only one patient underwent surgery.Conclusion: Although clinical and radiological findings of patients with GM may mimic those of breast carcinoma, our study showed that women of childbearing age, especially among Hispanic ethnicity with a recent history of pregnancy or high prolactin level and newly tender mass-like lesion, in addition to new focal asymmetry on mammogram and heterogeneous hypoechoic irregular-shaped mass on ultrasound exam, should raise concern for GM. Non-invasive approach and clinical follow-up were the preferred treatment method. [ABSTRACT FROM AUTHOR]
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- 2018
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246. Granulomatous Lobular Mastitis: Clinicopathologic Presentation of 90 Cases.
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ÖZŞEN, Mine, TOLUNAY, Şahsine, and GÖKGÖZ, M. Şehsuvar
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CHRONIC granulomatous disease , *MASTITIS , *BREAST diseases , *SARCOIDOSIS , *TUBERCULOSIS - Abstract
Objective: Granulomatous lobular mastitis is a rare benign chronic breast disease first described by Milward in 1970, and then by Kessler and Wolloch in 1972. In this study, we aimed to present clinicopathologic features of granulomatous lobular mastitis with literature data. Material and Method: In this study, the archives of Uludag University Medical Faculty Department of Pathology were screened for granulomatous lobular mastitis cases between 2005 and 2017. Results: A total of 90 patients with granulomatous lobular mastitis diagnosed between 2005 and 2017 were identified. All of the cases were female. The mean age was 34+8.3 (range 21-60 years). There was sarcoidosis in one case and tuberculosis in another case, but no systemic disease was found in the charts of the other cases. Histopathological evaluation of 90 cases revealed non-necrotizing granulomas involving lobule-restricted, epithelioid histiocytes and Langhans-type multinuclear giant cells. There was no case of necrosis, including our only case with a history of tuberculosis. Conclusion: We conclude that our granulomatous lobular mastitis cases have similar characteristics with the series reported earlier, when all features are taken into consideration. [ABSTRACT FROM AUTHOR]
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- 2018
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247. Efficacy of topical clobetasol propionate in the treatment of idiopathic granulomatous mastitis.
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YAZICI ÖZGEN, Züleyha, CÖMERT, Elif, and UĞURLU, Mustafa Ümit
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STEROIDAL anti-inflammatory agents , *ERYTHEMA , *MASTITIS , *CUTANEOUS therapeutics , *PAIN management , *TREATMENT effectiveness , *RETROSPECTIVE studies , *THERAPEUTICS ,MASTITIS diagnosis - Abstract
Objectives: To evaluate the efficacy of topical clobetasol propionate 0.05% pomade in the treatment of idiopathic granulomatous mastitis. Patients and Methods: Twenty-one idiopathic granulomatous mastitis patients' clinical and histopathological findings were retrospectively reviewed. Those patients excluded from other etiologies were categorized as idiopathic granulomatous mastitis and treated with topical clobetasol propionate 0.05% pomade as an initial treatment. Results: All 21 patients with a final diagnosis of idiopathic granulomatous mastitis were women with the average age of 36.2+/-5.2 years. Of the 21 patients; erythema, induration and pain problems of 6 (28.5%) patients totally resolved without recurrence in 3 months follow-up period. Erythema, induration and pain problems of 7 (33.5%) patients were minimalized and stay stable in 3 months follow-up period. The symptoms of 8 (38%) did not change under topical clobetasol propionate treatment. None of the patients developed side or adverse effects due to topical steroid treatment and 6 of 18 patients with non-steroidal anti-inflammatory drugs (NSAIDs) complained of gastric pain. Conclusion:Topical steroid treatment is a safe treatment option for idiopathic granulomatous mastitis patients before systemic steroid and immunosuppressive treatments and also surgery. [ABSTRACT FROM AUTHOR]
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- 2018
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248. ماستيت گرانولوماتوس ايديوپاتيك: گزارش يك مورد
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خديجه توكلي, زهرابيگم موسوي, and كامبيز كامياب
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Introduction: Idiopathic granulomatous mastitis (IGM) is a rare benign breast disease. The importance of this disease relies on its similar clinical manifestation to those of mammary carcinoma and a group of mastitis with other causes. Case Report: The patient was a 32-year-old woman, that suddenly got fever, pain and swelling in left breast. In examination several masses were felt. Performed core needle biopsy reported IGM. Conclusion: Similarity of clinical presentations and diagnostic tests to the other kinds of mastitis and malignancies may lead to misdiagnosis and mistreatment, which imposes socioeconomic and psychological burden to patients. [ABSTRACT FROM AUTHOR]
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- 2018
249. Can Fine Needle Aspiration Cytology be Used as a "Proxy Gold Standard" to Diagnose Tuberculous Mastitis?
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Kamal, Meherbano M., Kulkarni, Hemant R., Makde, Manjiri M., and Munje, Radha
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TUBERCULOSIS treatment , *BAYESIAN analysis , *CROHN'S disease , *MASTITIS , *TREATMENT of mastitis , *DISEASE risk factors , *TUBERCULOSIS diagnosis , *BIOPSY , *CYTODIAGNOSIS , *NEEDLE biopsy , *TUBERCULOSIS , *DISEASE prevalence ,MASTITIS diagnosis - Abstract
Objective: To assess the performance of fine needle aspiration cytology (FNAC) in the diagnosis of tuberculosis mastitis. Materials and Methods: Diagnostic test performance evaluation using two methods--as compared to an alloyed gold standard as well as in the absence of a gold standard. Alloyed gold standard combined the results of acid fast bacilli in cytology smears, histopathological confirmation, and response to treatment. Bayesian estimation of test parameters was done in the absence of the gold standard. Results: FNAC was carried out in 6,496 consecutive cases of breast lump and 104 cases of granulomatous mastitis were detected. Both methods of test parameter estimation identified a high specificity of FNAC for the diagnosis of tuberculosis mastitis (98.9% and 98.4%, respectively). Estimation of sensitivity was falsely high (100%) using the alloyed gold standard because of a workup bias and falsely low (8.41%) using the Bayesian estimation because of low prevalence. Likelihood ratios by both methods suggested that FNAC has good discriminatory capability. Conclusion: In situations where prevalence of tuberculosis is high and where facilities for histopathological evaluation do not exist, FNAC can offer an optional alternative to base the therapeutic decision for starting antitubercular treatment. [ABSTRACT FROM AUTHOR]
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- 2018
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250. Differentiating benign and malignant inflammatory breast lesions: Value of T2 weighted and diffusion weighted MR images.
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Kanao, Shotaro, Kataoka, Masako, Iima, Mami, Ikeda, Debra Masako, Toi, Masakazu, and Togashi, Kaori
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INFLAMMATORY breast cancer , *BREAST cancer , *TISSUE wounds , *DIFFUSION coefficients , *MAGNETIC resonance mammography - Abstract
Objectives Benign and malignant inflammatory breast lesions demonstrate similar findings on both T2 weighted imaging (T2WI) and dynamic contrast enhanced (DCE) images. We hypothesized that benign inflammatory lesions might be differentiated form malignancies using a combination of apparent diffusion coefficient (ADC) values derived from diffusion weighted images (DWI) and T2WI. Materials and methods We retrospectively reviewed 162 patients undergoing breast MRI (T2WI, DWI and DCE images) between 2008 and 2015 who had breast lesions with high T2WI signal intensity (High T2 SI) including 14 benign inflammatory lesions, 69 benign non-inflammatory lesions, 16 malignant inflammatory lesions and 63 malignant non-inflammatory lesions. On the High T2 SI and low T2WI signal intensity (Low T2 SI) areas in these breast lesions, we calculated ADC values from b values of 0 and 1000 s/mm 2 . Results The mean ADC values ± standard deviation (10 −3 mm 2 /s) of the High T2 SI areas in benign inflammatory, benign non-inflammatory, malignant inflammatory and malignant non-inflammatory breast lesions were 0.75 ± 0.18, 1.77 ± 0.33, 2.06 ± 0.32 and 1.88 ± 0.41, respectively. Those of the Low T2 SI areas in benign inflammatory, benign non-inflammatory, malignant inflammatory and malignant non-inflammatory lesions were 0.89 ± 0.15, 1.31 ± 0.28, 0.87 ± 0.20 and 0.94 ± 0.27 respectively. ADC values of High T2 SI areas of the benign inflammatory lesions were significantly lower than those of benign non-inflammatory, malignant inflammatory, and malignant non-inflammatory lesions ( p < 0.001). ADC values of Low T2 SI areas in benign inflammatory lesions were not significantly different from those of malignant inflammatory ( p = 0.99) or malignant non-inflammatory lesions ( p = 0.72). Conclusion For breast lesions with High T2 SI, segmenting the High T2 SI for ADC mapping distinguishes benign from malignant inflammatory conditions. Using ADC mapping of the Low T2 SI areas will not result in this distinction. [ABSTRACT FROM AUTHOR]
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- 2018
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