Elsevier

Pathology

Volume 36, Issue 3, June 2004, Pages 254-257
Pathology

Granulomatous mastitis: a clinicopathological review of 26 cases

https://doi.org/10.1080/00313020410001692602Get rights and content

Summary

Aims

Twenty-six cases of granulomatous mastitis were examined to determine the common histological and clinical features and the possible association with micro-organisms. Methods: A retrospective review of the clinical and histological features of these cases was undertaken, including granuloma, inflammatory cell infiltrate, multinucleated giant cells, necrosis and lymphocytic lobulitis, as well as special stains for micro-organisms including Mycobacterium, other bacteria and fungus. PCR for Mycobacterium tuberculosis DNA was also performed in 19 cases.

Results

Granulomas were present in all cases (100%) while multinucleated giant cells were seen in 17 cases (65%), background inflammatory cell infiltrate in 23 cases (88%), predominantly lymphocytes in 18 cases (69%), significant lymphocytic lobulitis in 13 of 19 cases (68%) and necrosis in three cases (11%). Special stains and cultures for microorganisms were all negative. Clinically, four cases (15%) were associated with duct ectasia, eight (31%) with abscess, and there was no such association in 14 cases (54%). Of the 19 cases with PCR for tuberculosis, one case showed Mycobacterium DNA in the sample, raising the possibility of occult tuberculosis infection.

Conclusions

Granulomatous mastitis is a heterogeneous group of diseases with a diverse clinical picture and association. Most idiopathic cases are not associated with specific micro-organisms.

References (19)

  • KesslerE. et al.

    Granulomatous mastitis: a lesion clinically simulating carcinoma

    Am J Clin Pathol

    (1972)
  • FletcherA. et al.

    Granulomatous mastitis: a report of seven cases

    J Clin Pathol

    (1982)
  • GoingJ.J. et al.

    Granulomatous lobular mastitis

    J Clin Pathol

    (1987)
  • GaleaM.H. et al.

    Granulomatous lobular mastitis

    Aust NZ J Surg

    (1989)
  • BhaskaranC.S. et al.

    Chronic granulomatous mastitis: review of 26 cases with special reference to chronic lobular mastitis

    Indian J Pathol Microbiol

    (1992)
  • TaylorG.B. et al.

    A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis

    Pathology

    (2003)
  • EnginG. et al.

    Granulomatous mastitis: gray scale and color Doppler sonographic findings

    J Clin Ultrasound

    (1999)
  • HanB.K. et al.

    Granulomatous mastitis: mammographic and sonographic appearances

    Am J Radiol

    (1999)
  • YilmazE. et al.

    Mammographic and sonographic findings in the diagnosis of idiopathic granulomatous mastitis

    Eur Radiol

    (2001)
There are more references available in the full text version of this article.

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