Oztekin Pelin Seher, Durhan Gamze, Nercis Kosar Pinar, Erel Serap, Hucumenoglu Sema
Radiology Department, Ankara Training and Research Hospital, Ankara, Turkey.
4th Surgery Department, Ankara Training and Research Hospital, Ankara, Turkey.
Iran J Radiol. 2016 May 31;13(3):e33900. doi: 10.5812/iranjradiol.33900. eCollection 2016 Jul.
Granulomatous mastitis (GM) is a rare inflammatory breast disease that may mimic the clinical characteristics and radiologic imaging findings of breast carcinoma. Considering the importance of making a correct diagnosis, careful radiologic evaluations and recognition of imaging features are necessary.
The aim of this study was to review the radiological findings and diagnostic value of the imaging in GM.
This retrospective study involved a total of 29 patients who were diagnosed with GM between 2009 and 2013 and who underwent mammography (MG) and/or ultrasound (US) examination in addition to magnetic resonance imaging (MRI) before diagnosis.
Among 14 patients over 35 years of age who underwent MG imaging, focal asymmetric, ill-defined nodular, or diffusely increased densities were detected in nine (64.3%), two (14.3%), and one (7.1%) subjects, respectively, while there were no pathological findings in two (14.3%) patients. In the overall group of 29 patients, US showed heterogeneous hypoechoic lesions with tubular extensions in 16 (55.2%), well-demarcated heterogeneous hypoechoic lesions in eight (27.6%), parenchymal heterogeneous appearance in three (10.3%), and a heterogeneous hypoechoic lesion with irregular margins in one (3.4%), with another (3.4%) patient having normal US findings. MRI findings included lesions consistent with solitary or multiple separate or confluent abscesses with marked peripheral ring enhancement in 25 (86.2%) patients, accompanied by intensity changes suggesting edematous inflammation in the peripheral parenchyma, as well as non-mass-like heterogeneous segmental and regional contrast enhancement. Four (13.8%) patients had non-mass-like segmental and regional contrast enhancement only. A histopathological diagnosis of GM was established in all patients with biopsy.
GM presents with a wide range of conventional radiological findings, hampering the diagnosis. In patients with inconclusive conventional findings, MRI may assist in the differential diagnosis and assessment of the extent of disease. However, a definitive diagnosis and relevant treatment require histopathological confirmation.
肉芽肿性乳腺炎（GM）是一种罕见的炎性乳腺疾病，可能会模仿乳腺癌的临床特征和放射影像学表现。鉴于正确诊断的重要性，进行仔细的放射学评估并识别影像学特征是必要的。
本研究的目的是回顾GM的放射学表现及影像学检查的诊断价值。
这项回顾性研究共纳入了29例在2009年至2013年间被诊断为GM的患者，这些患者在诊断前除了接受磁共振成像（MRI）检查外，还接受了乳腺X线摄影（MG）和/或超声（US）检查。
在14例年龄超过35岁且接受MG成像检查的患者中，分别有9例（64.3%）、2例（14.3%）和1例（7.1%）检测到局灶性不对称、边界不清的结节状或弥漫性密度增加，而2例（14.3%）患者未发现病理改变。在29例患者的总体组中，US显示16例（55.2%）有伴有管状延伸的不均匀低回声病变，8例（27.6%）有边界清晰的不均匀低回声病变，3例（10.3%）有实质不均匀表现，1例（3.4%）有边缘不规则的不均匀低回声病变，另有1例（3.4%）患者US检查结果正常。MRI表现包括25例（86.2%）患者有与单个或多个单独或融合的脓肿一致的病变，伴有明显的外周环形强化，同时伴有提示外周实质水肿性炎症的信号改变，以及非肿块样不均匀节段性和区域性对比增强。4例（13.8%）患者仅有非肿块样节段性和区域性对比增强。所有活检患者均建立了GM的组织病理学诊断。
GM呈现出广泛的传统放射学表现，这给诊断带来了困难。对于传统检查结果不明确的患者，MRI可能有助于鉴别诊断和评估疾病范围。然而，明确诊断和相关治疗需要组织病理学证实。
