Kamyab Armin
Armin Kamyab, Department of Surgery, Cox Monett Hospital, Monett, MO 65708, United States.
World J Clin Cases. 2016 Dec 16;4(12):409-412. doi: 10.12998/wjcc.v4.i12.409.
Granulomatous lobular mastitis is a rare inflammatory disease of the breast of unknown etiology. Most present as breast masses in women of child-bearing age. A 29-year-old female presented with a swollen, firm and tender right breast, initially misdiagnosed as mastitis. Core needle biopsy revealed findings consistent with granulomatous lobular mastitis, and cultures were all negative for an infectious etiology. She was started on steroid therapy to which she initially responded well. A few weeks later she deteriorated and was found to have multiple breast abscesses. She underwent operative drainage and cultures grew . Granulomatous lobular mastitis is a rare inflammatory disease of the breast. The definitive diagnose entails a biopsy. Other causes of chronic or granulomatous mastitis should be ruled out, including atypical or rare bacteria such as . This is the first reported case of granulomatous mastitis secondary to . With pathologic confirmation of granulomatous mastitis, an infectious etiology must be ruled out. Atypical bacteria such as may not readily grow on cultures, as with our case. Medical management is appropriate, with surgical excision reserved for refractory cases or for drainage of abscesses.
肉芽肿性小叶性乳腺炎是一种病因不明的罕见的乳腺炎症性疾病。大多数表现为育龄期女性的乳腺肿块。一名29岁女性因右乳肿胀、坚硬且压痛就诊,最初被误诊为乳腺炎。粗针活检结果符合肉芽肿性小叶性乳腺炎,且感染性病因的培养均为阴性。她开始接受类固醇治疗,最初反应良好。几周后病情恶化,发现有多个乳腺脓肿。她接受了手术引流,培养发现……肉芽肿性小叶性乳腺炎是一种罕见的乳腺炎症性疾病。明确诊断需要活检。应排除慢性或肉芽肿性乳腺炎的其他病因,包括非典型或罕见细菌,如……这是首例继发于……的肉芽肿性乳腺炎报告病例。在肉芽肿性乳腺炎经病理证实后,必须排除感染性病因。与我们的病例一样,非典型细菌如……在培养中可能不易生长。药物治疗是合适的,手术切除仅适用于难治性病例或用于脓肿引流。