Granulomatous Lobular Mastitis: Antituberculous Treatment and Outcome in 22 Patients

Liu, Lu; Zhou, Fei; Zhang, Xiaoxia; Liu, Shuchen; Liu, Liyuan; Xiang, Yuzhi; Guo, Mingming; Cui, Shude; Wang, Fei; Ma, Zhongbing; Li, Liang; Gao, Dezong; Zhang, Qiang; Fu, Qinye; Zhang, Yu

doi:10.1159/000487935

Cited by 17 publications

(13 citation statements)

References 26 publications

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“…Other authors have described or presented images of histological features consistent with the CNGM pattern without appreciating the association with corynebacteria or using special stains (Gram) for the identification of GPB. Many of these cases are consequently diagnosed as IGM or chronic granulomatous mastitis 17–21…”

Section: Historical Overview and Histological Featuresmentioning

confidence: 99%

Cystic neutrophilic granulomatous mastitis: an update

Turashvili

2020

J Clin Pathol

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Cystic neutrophilic granulomatous mastitis (CNGM) is a rare subtype of granulomatous mastitis with a highly distinct histological pattern often associated with Corynebacterium species. CNGM is characterised by suppurative lipogranulomas that are composed of central lipid vacuoles rimmed by neutrophils and an outer cuff of epithelioid histiocytes. Some of the lipid vacuoles may contain sparse, rod-shaped, gram-positive bacilli that can be easily missed or dismissed. The surrounding mixed inflammatory infiltrate contains Langhans-type giant cells, lymphocytes and neutrophils. CNGM occurs in reproductive age women with a history of pregnancy and typically presents as a palpable mass that can be painful. CNGM has many mimickers, most significantly breast carcinoma. In many cases, CNGM has significant pathological and clinical overlap with other forms of granulomatous mastitis. Given the association with Corynebacterium species, early diagnosis of CNGM is essential in offering patients the most appropriate treatment. Prolonged antibiotic therapy specifically directed to corynebacteria is required, sometimes even beyond resolution of clinical symptoms. This comprehensive review of the existing literature on CNGM describes clinical–pathological features, microbiological findings, challenges associated with the microscopic differential diagnosis, clinical implications of this diagnosis and emerging treatment options. Morphological criteria and suggested comments to convey the degree of diagnostic certainty are also proposed for standard pathology reporting.

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Section: Historical Overview and Histological Featuresmentioning

confidence: 99%

Cystic neutrophilic granulomatous mastitis: an update

Turashvili

2020

J Clin Pathol

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“…The expression of C677T and A1298C MTHFR genes were observed at different loci. The transcript sequences for C677T and A1298C MTHFR genes were as follows: Mutant type C/C and wild type C/C; mutant type C/C and heterozygous C/C; mutant type C/C and mutant type T/T; heterozygous A/C and wild type C/C; heterozygous A/C and heterozygous C/T; heterozygous A/C and mutant type T/T; wild type A/A and wild type C/C; wild type A/A and heterozygous C/T; wild type A/A and mutant type T/T[ 3 , 4 ].…”

Section: Methodsmentioning

confidence: 99%

Relationship between granulomatous lobular mastitis and methylene tetrahydrofolate reductase gene polymorphism

Lei¹,

Yang²,

Miao³

et al. 2020

WJCC

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BACKGROUND Variations in the methylene tetrahydrofolate reductase ( MTHFR ) gene have been reported as risk factors for numerous conditions, including cardiovascular disease, thrombophilia, stroke, hypertension and pregnancy-related complications. Moreover, it was reported there is an association between breast cancer and mutations in MTHFR -C677T. However, whether there is an association between MTHFR gene polymorphism and granulomatous lobular mastitis or not has been rarely investigated. AIM To analyze the association between MTHFR gene polymorphism and granulomatous lobular mastitis. METHODS Fifty-one patients with granulomatous lobular mastitis admitted to The First Hospital of Kunming were selected as study samples. Their hospitalization time ranged from February 2018 to February 2019. The 51 patients were included in the experimental group, and another 51 women who underwent physical examination at The First Hospital of Kunming in the same period were included in the control group. Deoxyribonucleic acid and MTF R genetic polymorphism testing were performed in each group. The association between MTHFR gene polymorphism and granulomatous lobular mastitis was observed. RESULTS There were significant differences in genotype frequency and allele frequency of C/C and C/T between the experimental group and the control group (all P < 0.05). However, there was no significant difference in frequency of T/T genotype between the two groups ( P > 0.05). In addition, there was no significant difference in genotype frequency and allele frequency of A/A, A/C and C/C between the two groups ( P > 0.05). CONCLUSION MTHFR gene C677T locus polymorphism is closely related to granulomatous lobular mastitis.

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“…Many authors suggested that possible etiology of GM include breast infection with microbes, autoimmune disorders and hypeprolactinemia [2]. Uncertain etiology leads to nonoptimal treatment for GM and included watch and wait strategy, antibiotics, steroids and surgery as earliest and most widely used therapy [3][4][5][6][7][8]. In cases when GM is localized in only one part of the breast, local excision is used and radical treatment is recommended only for the most extensive forms, when all breast tissue is involved [2,3,5].…”

Section: Introductionmentioning

confidence: 99%

Idiopathic granulomatous mastitis - new approach in operative treatment

2022

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Introduction. Idiopathic granulomatous mastitis (GM) is described as a very rare, non-lactating, chronic mastitis that occurs primarily in women of childbearing age. Significant clinical problem related to GM is the diagnostic differentiation from breast cancer. Less advanced forms of GM can be successfully treated with limited surgical excisions and radical treatment is recommended only for the most extensive forms. Case report. First examination of the patient, by the surgeon at Oncology Institute of Vojvodina was in December 2018., when initial suspicion of breast cancer was set up. Core needle biopsy was performed and after histopathological (HP) analysis, confirmation of GM was obtained. The patient was initially offered Prednisone and Methotrexate therapy, which she refused and accepted only surgical treatment. Surgical treatment was performed few weeks after needle biopsy and consisted of performing a nipple spearing mastectomy with excision of the orifices of all fistulous ducts and their primary sutures. The HP findings of the operative specimen confirmed the diagnosis of GM. While there were no signs of dieses relapse, patient was suggested secondary reconstruction of the left breast. Twelve months after the primary operation, secondary breast reconstruction was performed with the interposition of a contoured silicone implant into a muscle pocket in a standard manner. Conclusion. Nipple spearing mastectomy with secondary breast reconstruction is aesthetically satisfactory treatment for patients with locally advanced GM.

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Granulomatous Lobular Mastitis: Antituberculous Treatment and Outcome in 22 Patients

Cited by 17 publications

References 26 publications

Cystic neutrophilic granulomatous mastitis: an update

Cystic neutrophilic granulomatous mastitis: an update

Relationship between granulomatous lobular mastitis and methylene tetrahydrofolate reductase gene polymorphism

Idiopathic granulomatous mastitis - new approach in operative treatment

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