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KMID : 0948320040040020162
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Konyang Medical Journal
2004 Volume.4 No. 2 p.162 ~ p.166
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Sonographic Finding and Clinical Significance of Granulomatous Mastitis
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Kim Keum-Won
Yoon Dae-Sung
Hwang Cheol-Mog
Cho Young-Jun
Park Yong-Sung
Chung Dong-Jin
Sul Hae-Joung
Kim Jae-Kyun
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Abstract
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The purpose of this study is to evaluate the clinical and sonographic findings of granulomatous mastitis and to know the usefulness of sonoguided core biopsy. We reviewed the clinical and radiologic findings of 4 patients (age range 30 to 44 years) with pathologically proven granulomatous mastitis. Three mammography were analized for the shape, margin of mass, microcalcification and skin thickening, Four ultrasonography were analized for the shape, margin, internal echo pattern, boundary, posterior echo pattern of mass, skin thickening, subcutaneousfat tissue obliteration, and location of lesions. USG-guided core biopsy (n=4) and excisional operation (n=2) were performed. All pathologic slides were analized for the granuloma involving the lobule, fat globule surrounding granuloma, and microabcess. Our cases showed palpable mass (4/4), pain (4/4) and serous nipple discharge (1/4). Mammography showed focal asymmetry (2/3), partially obscured margin (1/3), cooper’s ligament thickening (2/3), and skin thickening (1/3). Ultrasonography showed irregular shape (4/4), ill defined margin (4/4), heterogenonus internal echogenicity (3/4), thick boundary echogenicity (4/4) and subcutaneous fat obliteration (4/4). All cases were located at subareolar or less than 2 cm from nipple (4/4). Histopathologic examination showed granuloma involving lobule (4/4), fat globule surrounding granuloma (2/4), microabscess (4/4) and PCR for mycobacterium were negative in all cases. Granulomatous mastitis should be considered in differential diagnosis of child bearing age women with painful breast mass, showing irregular shaped heterogeneous hypoechoic mass and thick echogenic boundary in sonography. For final diagnosis of GM, all cases require correlation with radiologic, histopathologic and clinical features.
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KEYWORD
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Granulomatous mastitis, breast USG, Core biopsy
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