This Two patients underwent MR breast imaging at analysis was performed with a 1.5-T MR imaging system (Vision, Siemens, Erlangen, Germany). The images were viewed at a window width of 400 HU and a level of +40 HU. The scans were obtained by using 120 kVp, 225 mAs, and 1 : 1 pitch. Five-millimeter-collimation helical scans were obtained from the apex of the lung to the diaphragm. After a non-enhanced study of the entire breast was performed, 100 mL of contrast material (iopromide, Schering, Berlin, Germany) was injected at 2.5 mL/sec into an antecubital vein using a mechanical power injector (Medrad, Pittsburgh, PA, USA). One patient was examined with a Tomoscan SR-7000 spiral CT unit (Phillips Medical Systems, Best, Netherlands).
We also examined the 11 patients (12 lesions) using real-time sonography. All lesions were examined by routine mammography using both the craniocaudal and the mediolateral oblique views. We used a CGR 500T or GE DMR mammography unit (GE Medical Systems, Milwaukee, WI, USA), Acuson 128, Acuson 128/xp 3, Acuson 128/xp 10 (Acuson, Mountain View, CA, USA), and a Ultramark 9, HDI 3000 ultrasonography unit (Advanced Technology Laboratory, Bothell, WA, USA). Ten patients were examined by both mammography and sonography, while one patient was only examined by sonography. Other possible causes of granulomatous inflammatory lesions of the breast were excluded by serologic tests, histologic analysis by staining with either modified Ziehl-Neelsen, periodic acid-Schiff with diastase predigestion, or Gomori's methenamine silver stains, and by testing the effected tissue for aerobic and anaerobic bacteria, mycobacteria, and fungi. This inflammation consisted of epithelioid cells, Langhans-type giant cells, and lobular-confined neutrophils. A positive diagnosis of IGLM required a characteristic histological pattern of granulomatous inflammation. Ten patients were diagnosed within 15 years of their last pregnancy. The mean age of the 11 patients was 34.8 years (ranging from 29 to 42 years old). During this period, 11 women with 12 lesions (7 lesions in the left breast, 3 lesions in the right breast, and one case in both breasts) of IGLM were diagnosed and treated. We performed a retrospective study of records from our institution between January 1993 and December 2000. Both clinical information and the description of radiographic features of IGLM may aid in the differentiation between IGLM and breast cancer, however histological confirmation is still required for the proper diagnosis and treatment of the disorder. In conclusion, the sonographic features of IGLM show irregular or tubular hypoechoic masses with minimal parenchymal distortion.
Chronic mastitis of right breast tabular list skin#
Contrary to previous reports, skin changes and subareolar involvement were not rare occurrences in IGLM. Subcutaneous fat obliteration (12/12) and skin thickening (11/12) were also observed in these patients. In addition, patient sonograms showed irregular tubular lesions (7/12) or lobulated masses with minimal parenchymal distortion (2/12), parenchymal distortion without definite mass lesions (2/12), and one oval mass. The patient mammograms showed irregular ill-defined masses (7/11), diffuse increased densities (3/11), and one oval obscured mass. The sites that were the most frequently involved were the peripheral (6/12), diffuse, (3/12), and subareolar (3/12) regions of the breast. Ten patients were examined by both mammography and sonography and one by sonography alone. The ages of these women ranged between 29 and 42 years, with a mean age of 34.8 years. We performed a retrospective analysis of the clinical and radiographic features of 11 women with a total of 12 IGLM lesions. The aim of this study was to describe the radiological imaging and clinical features of IGLM in order to better differentiate this disorder from breast cancer. Idiopathic granulomatous lobular mastitis (IGLM), also known as idiopathic granulomatous mastitis, is a rare chronic inflammatory lesion of the breast that can clinically and radiographically mimic breast carcinoma.
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