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The Korean Journal of Pathology 2005;39(3): 181-186.
Clinicopathologic Features of Granulomatous Mastitis.
Yee Jeong Kim, Yoon Jung Choi, Ji Young Kim, Hee Jung Kim, Yang Soon Park, Soon Won Hong, Chanil Park, Doyil Kim, Hyde Lee, Woo Hee Jung
1Department of Pathology, Yong Dong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. jungwh96@yumc.yonsei.ac.kr
2Department of Surgery, Yong Dong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
3Department of Pathology, MizMedi Hospital, Seoul, Korea.
4Department of Surgery, MizMedi Hospital, Seoul, Korea.
5Department of Pathology, National Health Insurance Cooperation Ilsan Hospital, Goyang, Korea.
6Department of Pathology, Gangnam CHA Hospital, Pochon CHA University, Seoul, Korea.
ABSTRACT
BACKGROUND: Granulomatous mastitis (GM) is a rare chronic inflammatory condition that clinically mimics a carcinoma. The diagnosis of idiopathic GM depends on the exclusion of other granulomatous inflammations. The purpose of this study is to correlate the clinicopathological features of GM with etiologies. METHODS: We reviewed the clinical records of 58 cases that were histologically diagnosed as GM. We performed special stains for microorganisms such as Ziehl-Neelsen, periodic acid Schiff and gram stains, and polymerase chain reaction (PCR) for Mycobacterium tuberculosis (TB PCR). RESULTS: The mean age of patients was 35.3 years. Most patients were parous except three. Seven patients (12.1%) were related with pregnancy or lactation. TB PCR was positive in nine patients (15.5%). Five patients (8.6%) had gram positive bacilli that were recognizable as coryneform bacteria. Culture study demonstrated Staphylococcus aureus in only one case. Infectious GM had a greater tendency to form abscesses. Fat necrosis was more likely to be present in idiopathic GM, but other histological features were similar to each other. Twenty-two cases (37.9%) showed recurrence. CONCLUSIONS: We suggest that TB PCR and gram stain are essential tests for the differential diagnosis of GM, because the histologic features considerably overlap irrespective of the various etiologies.
Key Words: Granuloma; Mastitis; Tuberculosis; Corynebacterium; Polymerase chain reaction