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The breasts
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Idiopathic granulomatous mastitis is a rare condition in which a conspicuous non-caseating granulomatous inflammatory process is associated with the terminal duct lobular unit. Microabscess may be present as well as multinucleated giant cells. Although no infectious cause is identified in many cases, and the diagnosis of tuberculosis should always be excluded in the setting of a granulomatous inflammatory process, the presence of Corynebacterium has been noted in some cases (particularly those with microabscess formation). In other cases an autoimmune reaction may be responsible. Other processes associated with granulomas in the breast include sarcoidosis (see Chapter 8) and reactions to foreign material, such as silicone, also need to be excluded.
Breast
Published in Michael Gaunt, Tjun Tang, Stewart Walsh, General Surgery Outpatient Decisions, 2018
Pain, redness and swelling are the usual symptoms of breast sepsis, but these symptoms can also be caused by rare inflammatory breast conditions that are often diagnosed by exclusion, e.g. granulomatous mastitis.
Breast Abscess
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Jennifer Tomlins, Simon Tiberi
A 38-year-old female is seen in the breast clinic complaining of chronic pain and swelling of her right breast. She has two children and takes the oral contraceptive pill but is otherwise fit and well. On examination, there is a tender, irregular lesion in the lower outer quadrant of her right breast. A biopsy shows perilobular granulomatous inflammation and suppurative lipogranulomas and is culture positive for Corynebacterium kroppenstedtii. Idiopathic granulomatous mastitis is a rare inflammatory condition of unknown aetiology.It is often found in young, parous women a few years after pregnancy on the oral contraceptive pill. Clinical features are similar to those of a malignancy, which needs to be excluded.Other causes of granulomas, e.g. TB, sarcoidosis, fungal infection and Wegener's granulomatosis, must be excluded.An association with Corynebacterium species, particularly Corynebacterium kroppenstedtii, has been found. It is essential that deep tissue samples be sent for culture and the lab is alerted to clinical concern for Corynebacterium spp.Treatment requires an multidisciplinary team (MDT) approach and may involve a combination of surgery, antibiotics and steroids.
Response to Re: The Clinical Utility of Autoantibodies in Patients with Idiopathic Granulomatous Mastitis
Published in Journal of Investigative Surgery, 2022
The author(s) defined our hospital as "a small state hospital." However, our hospital is a prestigious training and research hospital with 385 specialists and capacity of 1250 patient beds. Our hospital is also the biggest hospital in Konya that has the patients not only from the city itself but also from the cities, towns, and villages nearby. There is a “Senology Clinic” that has been in service for more than ten years with 250 operations/year for breast cancer including oncoplastic surgery and reconstructions. There are two general surgery professors; one general surgery specialist and two general surgery residents working full-time on their working days in this clinic. In addition, this clinic has its own ultrasound, mammography, tomosynthesis, breast MR and interventional radiology units with a dedicated radiologist. There are many studies about idiopathic granulomatous mastitis published from our clinic [1–8]. Our hospital is a very important center in terms of breast diseases, considering both the bed capacity, the senology clinic and the publications on idiopathic granulomatous mastitis and other breast diseases.
New Findings on Autoimmune Etiology of Idiopathic Granulomatous Mastitis: Serum IL-17, IL-22 and IL-23 Levels of Patients
Published in Journal of Investigative Surgery, 2021
Mehmet Saydam, Kerim Bora Yilmaz, Mutlu Sahin, Hamdullah Yanik, Melih Akinci, Ibrahim Yilmaz, Sener Balas, Cem Azili, Mehmet Ali Gulcelik
Idiopathic Granulomatous Mastitis (IGM) is a benign chronic inflammatory breast disease that mimics breast cancer in radiological and clinical findings. The etiopathogenesis has not yet been fully elucidated [1]. The disease tends to be seen mostly in fertile, young women, often with a history of breastfeeding. The incidence and treatment protocols as well as the etiopathogenesis of the disease are controversial and a matter of debate. Actually, the definitive diagnosis of IGM is made by histopathological examination and exclusion of an identifying etiology [2,3]. In a study, Baslaim et al. reported that IGM represented 1.8% of 1106 cases of benign breast disorders [4]. Although IGM is believed to rarely occur in general, the rapid increase in the number of cases reported in the literature and publications from developed countries, accompanied by large series published in Asia and the Mediterranean region, are interpreted as making the diagnosis easier or as increasing the prevalence [3,5].
A Comparison of the Circulating Endocan Levels between the Inflammatory and Malignant Diseases of the Same Organ: The Breast
Published in Journal of Investigative Surgery, 2021
Idiopathic granulomatous mastitis (IGM), a benign chronic inflammatory condition of possibly autoimmune origin, poses a considerable diagnostic challenge by local manifestations typically mimicking breast carcinoma. Physical findings and radiological similarities underline its importance in its differential diagnosis with BC, since indications, such as skin retraction overlying the affected tissue, penetration of the pectoralis major muscle, nipple retraction, and rarely lymphadenopathy can mislead the clinician, and the probability of a routine radiologic evaluation, ultrasound, mammography, and even MRI discerning an inflammatory process from a tumoral process is very low [12].