1/13. Idiopathic granulomatous mastitis. Report of a case diagnosed with fine needle aspiration cytology.BACKGROUND: Idiopathic granulomatous mastitis (IGM) is a benign, inflammatory breast disease of unknown etiology. Although it is rare, it frequently presents in a manner similar to that of breast carcinoma. CASE: A 41-year-old female developed unilateral idiopathic granulomatous mastitis, diagnosed by fine needle aspiration cytology. The clinical presentation and mammographic findings were suspicious for carcinoma. Fine needle aspiration cytology showed granulomatous inflammation. Histopathologic examination revealed a noncaseating, granulomatous lesion. Further clinical, radiologic and laboratory investigations disclosed no etiology. Therefore, we considered the case to be idiopathic granulomatous mastitis. CONCLUSION: Cytologically it may be difficult to distinguish IGM from carcinoma of the breast. Typical cytologic findings of the lesion are helpful to rule out cancer. In the differential diagnosis, all known causes of granulomatous changes have to be excluded before a diagnosis of idiopathic granulomatous mastitis is made.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/13. F-18 FDG uptake in breast infection and inflammation.PURPOSE: Whole-body fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography (PET) scanning has been useful in the management of breast cancer. However, F-18 FDG uptake sometimes has been associated with benign breast disease. Four cases are reported of F-18 FDG breast uptake caused by infectious or inflammatory mastitis that mimics malignant disease. methods AND RESULTS: Two women had F-18 FDG whole-body scans for the evaluation of a large breast mass after inconclusive results of ultrasonography. In both cases, intense focal F-18 FDG breast uptake was noted that mimicked breast cancer. Histologic examination showed, in one patient, chronic granulomatous infiltration that likely represented tuberculous mastitis, because she showed a good clinical response to empirical anti-tuberculous treatment. The second patient had lactational changes associated with acute inflammation, and the culture grew staphylococcus aureus. The breast mass completely disappeared 3 weeks after a course of antibiotic treatment. The other two patients had staging F-18 FDG PET scans 1 and 12 months after lumpectomy for breast carcinoma to detect residual, recurrent, or metastatic disease. Both scans showed a ring-like uptake in the involved breast, with superimposed intense focal uptake suggesting tumor necrosis centrally and malignant foci peripherally. In both cases, histologic examination revealed hemorrhagic inflammation secondary to postsurgical hematomas and no evidence of malignancy. CONCLUSION: Acute or chronic infectious mastitis and postsurgical hemorrhagic inflammatory mastitis should be considered in patients who have a breast mass, especially those with a history of tenderness or surgery.- - - - - - - - - - ranking = 6keywords = inflammation (Clic here for more details about this article) |
3/13. Unusual presentation of granulocytic sarcoma in the breast: a case report and review of the literature.This is a case of granulocytic sarcoma presenting as bilateral breast masses in a 40-yr-old woman with concurrent unsuspected chronic myeloid leukemia diagnosed by fine-needle aspiration. The granulocytic differentiation was recognized on Diff-Quik-stained cytology smears and confirmed rapidly on flow cytometry on the same day. The breast has been reported to be an uncommon site for granulocytic sarcoma. We found that 38.8% of granulocytic sarcomas diagnosed by fine-needle aspiration in the English-language literature occurred in the breast. In the absence of clinical history or hematological abnormality, granulocytic sarcoma may be misdiagnosed, depending on the degree of myeloid differentiation present within the tumor. The differential diagnosis includes large-cell non-Hodgkin's lymphoma, lobular carcinoma of the breast, undifferentiated carcinoma, malignant melanoma, extramedullary hemopoiesis and inflammation. The key morphological features and useful ancillary tests are discussed.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/13. Imprint cytology of non-specific granulomatous mastitis.Non-specific granulomatous mastitis (NSGM) is a tumor-like inflammatory condition involving breast lobules. Its recognition is of great significance because of clinical masquerade to invasive carcinoma. A 25-year-old woman developed a palpable breast lump with clinical and mammographic findings suggestive of malignancy. touch imprint cytology of the excised lump was consistent with a granulomatous inflammation while histopathological examination documented a NSGM with central necrosis. Clinical, radiologic and laboratory testing failed to identify any specific causative agent.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
5/13. Diabetic (lymphocytic) mastopathy with exuberant lymphohistiocytic and granulomatous response: a case report with review of the literature.We report a case of a 66-year-old woman who presented with multiple painless masses in both breasts. Prior bilateral biopsies were diagnosed as Rosai-Dorfman disease (Sinus histiocytosis with Massive Lymphadenopathy). A recent lumpectomy specimen revealed a gray-white smooth cut surface with a discrete masslike lesion. The histopathology demonstrated a fibrotic breast parenchyma with foci of dense fibrosis and scattered inconspicuous breast epithelium surrounded by lymphocytes that formed aggregates and follicles with germinal centers. The inflammation was in a periductal, perilobular, and perivascular distribution. In addition, an exuberant inflammatory response with histiocytes and fibroblasts was present. This inflammatory response focally surrounded areas of fat necrosis and formed noncaseating granulomas with rare multinucleated giant cells. This process had infiltrative, ill-defined edges and involved the subcutaneous tissues. The overlying epidermis was normal. The final diagnosis was diabetic mastopathy with an exuberant lymphohistiocytic response. The differential diagnosis included Rosai-Dorfman disease, inflammatory myofibroblastic tumor, granulomatous mastitis, sclerosing lipogranulomatous response/sclerosing lipogranuloma, lupus panniculitis, and rheumatoid nodules. Immunohistochemical studies and flow cytometry confirmed the polyclonal nature of the lymphoid infiltrate. After the histologic evaluation, we inquired if the patient had a history of diabetes mellitus, and learned that she did have type 2 noninsulin-dependent diabetes mellitus. In conclusion, we report a case of diabetic mastopathy that presents with bilateral tumorlike masses and an unusual exuberant lymphohistiocytic response with granuloma formation. The pathologist may not be provided with a history of diabetes mellitus, but the characteristic fibrosis, lymphocytic ductitis/lobulitis, and sclerosing lobulitis with perilobular and perivascular lymphocytic infiltrates should provide clues for an accurate diagnosis, even when an exuberant and an unusual lymphohistiocytic response is present. A timely accurate diagnosis can help limit repeat surgeries in this vulnerable group of patients.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/13. inflammation and adenoma in an axillary breast.The clinical and pathological data of a case of inflammation and adenoma in an axillary breast is reported. Associated potential hazards are discussed and the literature briefly reviewed. The above case comprises the first published case from ethiopia.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
7/13. Reactions at silicone-injected sites on the face associated with silicone breast implant "inflammation" or "rejection".Although complications in various parts of the body have been suggested as being produced when silicone mammary implants are "rejected" or produce inflammation, there have apparently been no reports describing "flares" at previous sites of facial silicone injections as complications of mammary silicone implants. Such reactions appear to be comparable to so-called "systemic contact dermatitis." However, in the absence of results of skin testing, the mechanism of such "ectopic" flares remains in doubt.- - - - - - - - - - ranking = 5keywords = inflammation (Clic here for more details about this article) |
8/13. Surgical management of silicone mastitis.The results of the operative treatment of 22 cases of silicone mastitis are presented. Moderate involvement can usually be managed successfully by local excision of the masses, or by a subcutaneous mastectomy with later reconstruction. patients with severe skin infiltration and/or pectoral muscle involvement are prone to complications, however, and we now believe an aggressive approach--such as a complete mastectomy with nipple banking and excision of the infiltrated muscle, might be best. This would allow the later reconstruction to proceed in relatively uninvolved tissue, and prevent the problems of recurrent inflammation from placing bag-gel prostheses in a residual bed of silicone-infiltrated tissue.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
9/13. Duct ectasia in the male.Three cases of inflammatory duct ectasia occurring in the male breast are described. The clinical presentation of the disease in the male closely resembles that in the female. Nipple retraction, nipple discharge, periareolar inflammation and bilateral involvement are all seen. Conservation measures produced unsatisfactory results similar to those in women. A similar operative approach to that used in women is advocated.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
10/13. Idiopathic granulomatous mastitis. Report of a case clinically and mammographically simulating breast carcinoma.A case of bilateral idiopathic granulomatous mastitis in a 67-year-old woman is described. The clinical presentation and mammographic findings raised strong suspicions of malignancy, excluded by the histological examination, which made it possible also to rule out possible known causes of granulomatous inflammation of the breast.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
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