Pathology & Cytology Dalarna, Region Dalarna, Falun, Sweden.
Clinical Microbiology, Uppsala University, Uppsala, Sweden.
Virchows Arch. 2021 Dec;479(6):1091-1094. doi: 10.1007/s00428-021-03098-2. Epub 2021 Apr 13.
Granulomatous mastitis is a rare inflammatory disease of varying etiology. Tuberculosis and cystic neutrophilic granulomatous mastitis caused by Corynebacterium are the best-established infectious examples. Despite the increasing incidence of Rickettsia-related diseases worldwide, granulomatous inflammation of breast parenchyma caused by Rickettsia has not yet been reported. We present a unique case of bilateral granulomatous mastitis documented with mammography, magnetic resonance imaging and core-needle biopsy. The rickettsial etiology of the disease was proved with specific immunohistochemistry and confirmed with DNA extraction, PCR and serology. The lesions completely resolved after a full-course tetracycline treatment. This case report widens the knowledge about the possible clinical manifestations of Rickettsia infection and adds a new bacterium to the list of etiological factors causing granulomatous mastitis.
肉芽肿性乳腺炎是一种罕见的病因不明的炎症性疾病。分枝杆菌引起的结核性和囊性中性粒细胞性肉芽肿性乳腺炎是最明确的感染性疾病。尽管全世界与立克次体相关的疾病发病率不断上升，但尚未有报道称立克次体引起乳腺实质的肉芽肿性炎症。我们报告了一例独特的双侧肉芽肿性乳腺炎病例，该病例通过乳房 X 线摄影、磁共振成像和空心针活检得到证实。通过特定的免疫组织化学证实了疾病的立克次体病因，并通过 DNA 提取、PCR 和血清学证实了病因。在四环素全程治疗后，病变完全消退。本病例报告拓宽了人们对立克次体感染可能临床表现的认识，并将一种新的细菌添加到引起肉芽肿性乳腺炎的病因因素列表中。
