Department of Obstetrics and Gynaecology C, Ibn Rochd University Hospital, School of Medicine and Pharmacy, Aïn Chok University, Casablanca, Morocco.
Diagn Interv Imaging. 2012 Jul;93(7-8):586-96. doi: 10.1016/j.diii.2012.04.028. Epub 2012 Jun 5.
Idiopathic granulomatous mastitis is a benign lesion of the mammary gland characterised by the presence of non-infectious inflammatory breast lesions limited to the lobules.
We report twenty cases of idiopathic granulomatous mastitis (IGM) with a discussion of epidemiology, clinical and diagnostic features, treatment and progress of this pathological entity.
A retrospective study of twenty cases compiled from a ten-year period, from 952 pathological anatomy examinations carried out to investigate various breast pathologies.
The patients had a mean age of 45.5 years. Clinical examinations revealed a tumefaction measuring between 2.5 and 18 cm in diameter. The mean size was 5.5 cm. Mammography showed nodular lesions and sonography demonstrated hypoechoic nodules. On histological examination there was a granulomatous inflammatory infiltrate of epithelioid and giant cells, without caseation necrosis, made up of lymphocytes, plasma cells and neutrophils. Microbiology investigations were negative. Lesion involvement was principally lobulocentric. Surgical excision of the lesions was combined with corticosteroid therapy in twelve cases, with non-steroidal anti-inflammatory drugs in another four and with antibiotic therapy in four cases. The patients made good progress in the short-term.
IGM is a rare entity. It poses a problem of differential diagnosis because it clinically resembles other forms of mastitis. The diagnosis can be made with certainty on histological studies. The treatment is medical alongside surgical excision. The prognosis of this disease remains favourable.
特发性肉芽肿性乳腺炎是一种良性乳腺病变，其特征为局限于小叶的非传染性炎症性乳腺病变。
我们报告了 20 例特发性肉芽肿性乳腺炎（IGM）病例，讨论了该病理实体的流行病学、临床和诊断特征、治疗和进展。
回顾性研究了 20 例病例，这些病例是从 952 例进行各种乳腺病理学检查的病理解剖检查中收集的，历时 10 年。
患者的平均年龄为 45.5 岁。临床检查显示肿块直径在 2.5 至 18 厘米之间，平均大小为 5.5 厘米。乳房 X 线摄影显示结节状病变，超声显示低回声结节。组织学检查显示有上皮样和巨细胞的肉芽肿性炎症浸润，无干酪样坏死，由淋巴细胞、浆细胞和中性粒细胞组成。微生物学检查为阴性。病变主要为小叶中心性。12 例患者行病变切除术联合皮质类固醇治疗，4 例患者行非甾体抗炎药治疗，4 例患者行抗生素治疗。患者在短期内病情好转。
IGM 是一种罕见的疾病。它具有临床类似于其他形式乳腺炎的问题，因此存在鉴别诊断的问题。组织学研究可以明确诊断。治疗是药物治疗联合手术切除。该疾病的预后仍然良好。
