Memis A, Bilgen I, Ustun E E, Ozdemir N, Erhan Y, Kapkac M
Department of Radiology, Medical School of Ege University, 35100, Izmir, Turkey.
Clin Radiol. 2002 Nov;57(11):1001-6. doi: 10.1053/crad.2002.1056.
The purpose of this study is to evaluate the mammographic and ultrasonographic characteristics of granulomatous mastitis and to correlate the imaging features with the histologic findings.
MATERIALS-METHODS: 15 patients with diagnosis of idiopathic granulomatous mastitis were examined with mammography and ultrasonography. The clinical, pathologic and imaging features were retrospectively reviewed and correlated in all patients.
Mammographic examination showed an asymmetric density with no distinct margins in 8 patients and an ill-defined mass in 3 patients. In 4 cases, no abnormal finding was detected on the mammography. Sonographic examination demonstrated an irregular mass with tubular connections in 5 patients, single or multiple hypoechoic tubular/nodular structures in 6, and focally or segmentally decreased parenchymal echogenity with acoustic shadowing in 4 patients. The imaging findings suggested a malignant tumor in 7 patients, while an inflammatory process or intraductal papilloma was considered in the differential diagnosis of the other patients.
Granulomatous mastitis usually presents with clinical findings mimicking a carcinoma. The most common mammographic appearance of the lesion is an asymmetrically increased density, which is not characteristic for this entity. Sonographic patterns of the disease are varied and appear to relate to the histologic features. Findings include a mass-like appearance, tubular/nodular hypoechoic structures and focal decreased parenchmal echogenicity with acoustic shadowing. With awareness of the findings granulomatous mastitis can be considered in the differential diagnosis.
本研究的目的是评估肉芽肿性乳腺炎的乳腺X线和超声特征，并将影像学特征与组织学结果相关联。
对15例诊断为特发性肉芽肿性乳腺炎的患者进行了乳腺X线和超声检查。对所有患者的临床、病理和影像学特征进行回顾性分析并相互关联。
乳腺X线检查显示，8例患者有不对称密度且边界不清，3例患者有边界不清的肿块。4例患者乳腺X线检查未发现异常。超声检查显示，5例患者有不规则肿块并伴有管状连接，6例患者有单个或多个低回声管状/结节状结构，4例患者有局灶性或节段性实质回声减低并伴有声影。7例患者的影像学表现提示为恶性肿瘤，其他患者的鉴别诊断考虑为炎症过程或导管内乳头状瘤。
肉芽肿性乳腺炎通常表现出类似癌的临床表现。该病变最常见的乳腺X线表现是不对称性密度增加，这对该疾病并不具有特征性。该疾病的超声表现多样，似乎与组织学特征有关。表现包括肿块样外观、管状/结节状低回声结构以及伴有声影的局灶性实质回声减低。认识到这些表现后，肉芽肿性乳腺炎可在鉴别诊断中予以考虑。
