Cytomorphological Spectrum of Granulomatous Mastitis: A Study of 33 Cases

Chandanwale, Shirish S; Naragude, Piyusha; Shetty, Abhinav; Sawadkar, Manoj; Raj, Akshi; Bhide, Aniket; Singh, Madhuri

doi:10.5152/ejbh.2020.5185

Cited by 16 publications

(14 citation statements)

References 18 publications

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“…The aetiology of granulomatous mastitis has not been established, as various agents have been considered to date [3][4][5]. Various aetiologies have been postulated and propounded, such as tuberculosis, sarcoidosis, foreign body reactions, fungal and parasitic infections, and autoimmunity [6]. It occurs more commonly in women of childbearing age.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Granulomatous Lobular Mastitis: An Imitation of Breast Carcinoma

Aydin¹,

Kesicioğlu²,

Vural³

et al. 2021

Cureus

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Since idiopathic granulomatous lobular mastitis, also known as idiopathic granulomatous mastitis or granulomatous lobulitis, was first described by Kessler and Wolloch in 1972, no consensus on the ideal and definitive treatment for this phenomenon has been reached thus far. Idiopathic granulomatous lobular mastitis mostly frequently observed in women of childbearing age within a few years of pregnancy with a higher incidence in patients of Hispanic, Native American, Middle Eastern, and African descent. This entity, per se, is a rare, benign, chronic inflammatory breast condition of unknown aetiology mimicking two common breast disorders. The first is breast inflammations or infection, such as cystic neutrophilic granulomatous mastitis; granulomatous mastitis due to Corynebacterium; other infections with granulomas, mycobacteria, fungi, cat scratch disease, and Brucella; granulomatosis with polyangiitis (Wegener's granulomatosis); sarcoidosis; and squamous metaplasia of lactiferous ducts. The second is breast carcinoma in some challenging cases. Of note, no consensus, per se, has been declared on its therapeutic management. The following vignette case described in this report involves idiopathic granulomatous lobular mastitis imitating breast carcinoma. It is important to note that, the aetiology of idiopathic granulomatous lobular mastitis is unknown, its diagnosis is difficult, and physicians should be vigilant and aware of this condition in order of abstaining from an overtreatment for malignancy or overlooking a true malignancy.

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Section: Discussionmentioning

confidence: 99%

Idiopathic Granulomatous Lobular Mastitis: An Imitation of Breast Carcinoma

Aydin¹,

Kesicioğlu²,

Vural³

et al. 2021

Cureus

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“…Breast TB was initially classified as primary when no other focus of TB was detectable, and secondary when it was associated with another focus of TB elsewhere in the body ( 12 ). Later, it was reported that breast TB is usually secondary, even if no other focus of TB was clinically or radiologically evident ( 13 ). We found other sites of TB associated with breast TB in 18.1% of the cases, while a previous study reported a rate of 67.9%, which was mostly represented by pleural and pulmonary TB ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Breast tuberculosis: a diagnosis not to be forgotten

Hammami¹,

Hentati²,

Chakroun³

et al. 2021

J Turkish German Gynecol Assoc

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Objective: To study the clinical characteristics and imaging features of breast tuberculosis (TB) and to describe treatment. Material and Methods: A retrospective study including all patients hospitalized in the infectious diseases department for breast TB between 1997 and 2018. Results: Twenty-two women, with a mean age of 39±12 years, were identified. In total, 18 patients were multiparous (81.8%). Both lump and mastalgia were the presenting symptoms in 19 cases (86.3%). Ipsilateral axillary lymphadenopathy was noted in 14 cases (63.6%). The most common finding on ultrasound was a well or poorly defined mass lesion, noted in 17 cases (77.2%), followed by fistulous tracts in seven cases (31.8%). Mammography showed focal, asymmetric breast density in 17 cases (89.5%) and diffuse in two cases (10.5%). The diagnosis was confirmed based on the presence of epithelioid cell granulomas and caseous necrosis in 13 cases (59.1%). Patients received antitubercular therapy for a mean duration of 11±5 months. The disease evolution was favorable in 20 cases (91%). There were two relapsing cases (9%). Conclusion: Breast TB should be considered in the differential diagnosis of young patients presenting with palpable lump with axillary lymphadenopathy, especially in endemic regions. The diagnosis confirmation usually requires an excision biopsy providing histological or bacteriological evidence.

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“…Moreover, tuberculous mastitis prominently involves the ductal structures. 6,45,46 Marked eosinophilic infiltration is often suggestive of fungal or parasitic infestations. Also, eosinophilic infiltration within vessel walls and breast tissue can be seen in Eosinophilic Granulomatosis with Polyangiitis.…”

Section: Cystic Neutrophilic Granulomatous Mastitis (Cngm)mentioning

confidence: 99%

Idiopathic Granulomatous Mastitis: Diagnosis and Histopathologic Features, A Review

et al. 2022

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Background: Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory breast condition, mostly affecting women of reproductive age within a few years of pregnancy. Due to diverse clinical and radiologic features, IGM can mimic a vast spectrum of breast conditions. Therefore, histological findings are one of the most essential bases of diagnosis. Methods: A literature search was performed to review the characteristics of IGM with an emphasis on histopathological features in English sources from 2010 to 2022. The key words used for PubMed database search were “breast”, “granulomatous mastitis”, “histopathology”, and “pathology.” Results: In total, 192 articles were retrieved, from which 38 most relevant manuscripts were selected for this review article. Conclusion: The diagnosis of IGM depends on clinical, radiologic, and pathologic findings. Palpable mass is the most frequent complaint. An irregular hypoechoic mass with varying degrees of posterior phenomena is the most common sonographic finding. Histologically, IGM is characterized by a non-caseating lobulocentric granulomatous inflammation; composed of tight aggregates of epithelioid histiocytes with or without multinucleated giant cells. At times, the presence of cystic empty vacuoles lined by neutrophils is noted that is commonly associated with cystic neutrophilic granulomatous mastitis (CNGM), a variant of IGM. Atypical findings for IGM includes: The presence of atypia and/or malignancy, caseous necrosis, marked eosinophilic infiltration, absence of granulomatous inflammation, etc.

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Cytomorphological Spectrum of Granulomatous Mastitis: A Study of 33 Cases

Cited by 16 publications

References 18 publications

Idiopathic Granulomatous Lobular Mastitis: An Imitation of Breast Carcinoma

Idiopathic Granulomatous Lobular Mastitis: An Imitation of Breast Carcinoma

Breast tuberculosis: a diagnosis not to be forgotten

Idiopathic Granulomatous Mastitis: Diagnosis and Histopathologic Features, A Review

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