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Rakotoarisaona MF, Razafimaharo TI, Razanakoto NH, Sendrasoa FA, Ducournau A, Devalland C, Dupond AS, Ranaivo IM, Ramarozatovo LS, Rapelanoro Rabenja F. Idiopathic Granulomatous Mastitis as an Unusual Cause of Erythema Nodosum in a Malagasy Woman. Int Med Case Rep J 2023; 16:159-165. [PMID: 36936184 PMCID: PMC10016364 DOI: 10.2147/imcrj.s403050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
Introduction Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease. Neoplastic and infectious etiologies must be ruled out. IGM is a diagnostic challenge for countries with high tuberculosis endemicity like Madagascar since it may clinically and radiologically mimic breast tuberculosis. We report a case of IGM associated with erythema nodosum in a Malagasy. Case Report A 29-year-old primiparous woman came to a dermatological consultation for typical erythema nodosum lesions that appeared one month after a breast swelling. She had no particular medical history. Examination revealed typical erythema nodosum lesions on the legs, voluminous tender mass in the right breast. Bacteriological samples and tuberculosis test were negative. Imaging showed mastitis on the right breast with no evidence of malignancy. Histology revealed a non-caseating granulomas on the lobule of the right breast. As part of an etiological work-up, COVID-19 serology was performed with a positive IgG antibody. The diagnosis of IGM associated with erythema nodosum was evocated. The evolution was favorable under systemic corticosteroid therapy. Discussion The cause of this uncommon lesion remains obscure. The extramammary localizations such as erythema nodosum and arthralgia suggest an autoimmune origin. This pathogenesis is also reinforced by a good response to systemic immunosuppression. In our patient, the etiological assessment of the mastitis revealed a chronic infection with SARS-CoV-2. Histopathology is the gold standard for the IGM diagnosis which demonstrates a lobulocentric granulomas without caseous necrosis. Oral corticosteroid therapy is the initial choice of treatment. Conclusion Now, with several cases of concomitant IGM and EN reported, dermatologists should be aware that erythema nodosum can be one of the presenting signs of IGM, since the two conditions appear to be associated. The particularity of our case lies in the incidental discovery of SARS-CoV-2 infection. Is a chronic granulomatous disease associated with SARS-CoV-2 infection, a coincidence?
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Affiliation(s)
- Mendrika Fifaliana Rakotoarisaona
- Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar
- Correspondence: Mendrika Fifaliana Rakotoarisaona, Department of Dermatology, University Hospital Joseph Raseta Befelatanana, Rue Dr Davioud Jacques, Antananarivo, 101, Madagascar, Tel/Fax +261 34 61947 34, Email
| | | | | | | | - Anne Ducournau
- Department of Dermatology, Nord Franche-Comté Hospital, Trevenans, France
| | | | - Anne-Sophie Dupond
- Department of Dermatology, Nord Franche-Comté Hospital, Trevenans, France
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Zheng Y, Bai L, Sun J, Zhu L, Huang R, Duan S, Dong F, Tang Z, Li Y. Diagnostic value of radiomics model based on gray-scale and contrast-enhanced ultrasound for inflammatory mass stage periductal mastitis/duct ectasia. Front Oncol 2022; 12:981106. [PMID: 36203455 PMCID: PMC9530941 DOI: 10.3389/fonc.2022.981106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/29/2022] [Indexed: 12/24/2022] Open
Abstract
ObjectiveThe present study aimed to investigate the clinical application value of the radiomics model based on gray-scale ultrasound (GSUS) and contrast-enhanced ultrasound (CEUS) images in the differentiation of inflammatory mass stage periductal mastitis/duct ectasia (IMSPDM/DE) and invasive ductal carcinoma (IDC).MethodsIn this retrospective study, 254 patients (IMSPDM/DE: 129; IDC:125) were enrolled between January 2018 and December 2020 as a training cohort to develop the classification models. The radiomics features were extracted from the GSUS and CEUS images. The least absolute shrinkage and selection operator (LASSO) regression model was employed to select the corresponding features. Based on these selected features, logistic regression analysis was used to aid the construction of these three radiomics signatures (GSUS, CEUS and GSCEUS radiomics signature). In addition, 80 patients (IMSPDM/DE:40; IDC:40) were recruited between January 2021 and November 2021 and were used as the validation cohort. The best radiomics signature was selected. Based on the clinical parameters and the radiomics signature, a classification model was built. Finally, the classification model was assessed using nomogram and decision curve analyses.ResultsThree radiomics signatures were able to differentiate IMSPDM/DE from IDC. The GSCEUS radiomics signature outperformed the other two radiomics signatures and the AUC, sensitivity, specificity, and accuracy were estimated to be 0.876, 0.756, 0.804, and 0.798 in the training cohort and 0.796, 0.675, 0.838 and 0.763 in the validation cohort, respectively. The lower patient age (p<0.001), higher neutrophil count (p<0.001), lack of pausimenia (p=0.023) and GSCEUS radiomics features (p<0.001) were independent risk factors of IMSPDM/DE. The classification model that included the clinical factors and the GSCEUS radiomics signature outperformed the GSCEUS radiomics signature alone (the AUC values of the training and validation cohorts were 0.962 and 0.891, respectively). The nomogram was applied to the validation cohort, reaching optimal discrimination, with an AUC value of 0.891, a sensitivity of 0.888, and a specificity of 0.750.ConclusionsThe present study combined the clinical parameters with the GSCEUS radiomics signature and developed a nomogram. This GSCEUS radiomics-based classification model could be used to differentiate IMSPDM/DE from IDC in a non-invasive manner.
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Affiliation(s)
- Yan Zheng
- Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lu Bai
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jie Sun
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Lin Zhu
- Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Renjun Huang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shaofeng Duan
- Precision Health Institution, GE Healthcare, Shanghai, China
| | - Fenglin Dong
- Department of Ultrasound, The First Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Fenglin Dong, ; Zaixiang Tang, ; Yonggang Li,
| | - Zaixiang Tang
- Department of Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
- *Correspondence: Fenglin Dong, ; Zaixiang Tang, ; Yonggang Li,
| | - Yonggang Li
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Medical Imaging, Soochow University, Suzhou, China
- National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
- Suzhou Key Laboratory of Intelligent Medicine and Equipment, Soochow University, Suzhou, China
- *Correspondence: Fenglin Dong, ; Zaixiang Tang, ; Yonggang Li,
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Li C, Yao M, Li X, Shao S, Chen J, Li G, Jia C, Wu R. Ultrasonic multimodality imaging features and the classification value of nonpuerperal mastitis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:675-684. [PMID: 35475482 DOI: 10.1002/jcu.23205] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/12/2022] [Accepted: 03/04/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the value of ultrasonic multimodality imaging for characterizing nonpuerperal mastitis (NPM) lesions and feasibility of distinguishing different subtypes. METHODS Thirty-eight NPM lesions were assessed using conventional ultrasonography (US), strain elastography (SE), and contrast-enhanced ultrasound (CEUS). The lesions were confirmed pathologically and classified as granulomatous lobular mastitis (GLM), plasma cell mastitis (PCM), or nonspecific mastitis (NSM). Furthermore, diagnostic indicators were evaluated. The diagnostic performances of the modalities were compared using the area under the receiver operating characteristic curve (AUC). RESULTS The overall morphological features on US differed significantly between the GLM and PCM groups (p = 0.002). Lesion size (≤10 mm) (p = 0.003) and mean SE score (p = 0.001) differed significantly between the PCM and NSM groups. The frequent NPM characteristic on CEUS was hyperenhancement with (or without) increased lesion size; intergroup differences were not significant. Breast Imaging Reporting and Data System > 3 was considered to indicate malignancy; accordingly, the accuracy of US alone, US with CEUS, and US with SE was 10.5%, 21.1%, and 65.8%, respectively. Moreover, the AUC for US with SE for classifying GLM and PCM was 0.616. CONCLUSION CEUS cannot accurately classify NPM subtypes, while US and SE are valuable for classification.
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Affiliation(s)
- Chunxiao Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minghua Yao
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sihui Shao
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Chen
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Gang Li
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chao Jia
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Wu
- Department of Ultrasound, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Xing M, Zhang S, Zha X, Zhang J. Current Understanding and Management of Plasma Cell Mastitis: Can We Benefit from What We Know? Breast Care (Basel) 2022; 17:321-329. [PMID: 35949416 PMCID: PMC9247483 DOI: 10.1159/000517572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/20/2021] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Plasma cell mastitis (PCM), also known as mammary duct ectasia, is a chronic nonbacterial breast inflammation characterized by duct expansion and plasma cell infiltration. The severe and intense clinical manifestations profoundly affect the quality of life of female patients. Although the pathological process of PCM is known to include four stages (duct dilatation, inflammation, abscess and fistula), there is still lack of imaging techniques and serum markers with high specificity in clinical practice. Due to recurrent acute attacks and the prolonged healing process of the disease, most patients choose to accept mastectomy. SUMMARY We searched for studies, reports and reviews referring to PCM in the past 20 years; more than half of the results were related to animal studies, and little attention has been paid to human beings, which may explain the frequent misdiagnosis of PCM as breast cancer and the limited treatment options. This review focuses on the current diagnostic methods and markers for PCM and hierarchically discusses the typical clinical features, etiological causes and relevant molecular mechanisms of PCM. KEY MESSAGES We herein highlight the urgent need to develop more specific and sensitive biomarkers in the clinical laboratory. It will help to establish a standardized flowchart for the diagnosis and treatment of PCM in order to improve recovery for female patients.
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Affiliation(s)
- Mengying Xing
- Department of Laboratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shichang Zhang
- Department of Laboratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoming Zha
- Department of Breast Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiexin Zhang
- Department of Laboratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Guo W, Li W, Su Y, Liu S, Kan X, Ran X, Cao Y, Fu S, Liu J. GPR109A alleviate mastitis and enhances the blood milk barrier by activating AMPK/Nrf2 and autophagy. Int J Biol Sci 2021; 17:4271-4284. [PMID: 34803497 PMCID: PMC8579459 DOI: 10.7150/ijbs.62380] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/04/2021] [Indexed: 02/01/2023] Open
Abstract
Mastitis causes great psychological and physical pain among women. Our previous studies found that niacin has anti-inflammatory effect, and the realization of this function depends on GPR109A. However, there are no previous reports about the anti-inflammatory function of GPR109A in mastitis. In our study, we observed the effect of niacin on the WT and GPR109A-/- mice mastitis model. The results showed that administration of niacin to WT mice reduced the damage, proinflammatory mediators and protected the integrity of the blood milk barrier in mammary gland. While in GPR109A-/- mice, there was no effect on the above indexes. In mammary epithelial cells, GPR109A was able to promote autophagy and Nrf2 nuclear import through AMPK. In LPS-induced mammary epithelial cells, niacin inhibited the LPS-induced inflammatory response and downregulation of tight junction proteins, and these effects were eliminated by knocking down GPR109A, blocking autophagy or inhibiting Nrf2 nuclear import. These results indicate that in mastitis, GPR109A promotes autophagy and Nrf2 nuclear import through AMPK, thereby inhibiting inflammatory damage to the mammary gland and repairing the blood milk barrier. Our results suggested that GPR109A may be a potential target for the treatment of mastitis.
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Affiliation(s)
- Wenjin Guo
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Wen Li
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Yingchun Su
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Shu Liu
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Xingchi Kan
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Xin Ran
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Yu Cao
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Shoupeng Fu
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Juxiong Liu
- College of Veterinary Medicine, Jilin University, Changchun 130062, China
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Geffroy D. La peau des seins, première frontière anatomique. IMAGERIE DE LA FEMME 2020. [DOI: 10.1016/j.femme.2020.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Faye M, Ndiaye B, Diémé EGPA, Sall I, Faye ST, Fall O, Sow A. [Breast abscess: epidemiological, diagnostic and therapeutic features in patients hospitalized in the Main Hospital in Dakar]. Pan Afr Med J 2020; 37:16. [PMID: 33062118 PMCID: PMC7532858 DOI: 10.11604/pamj.2020.37.16.24694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 07/12/2020] [Indexed: 11/11/2022] Open
Abstract
Les abcès du sein sont des collections purulentes néoformées au niveau de la glande mammaire et du tissu péri glandulaire. Ils peuvent être lactants ou non lactants. L’objectif de notre étude était de décrire leurs caractéristiques épidémiologiques, diagnostiques et thérapeutiques au Service de Chirurgie Générale de l’Hôpital Principal de Dakar. Nous avions réalisé une étude rétrospective, descriptive sur une période de 4 ans portant sur tous les patients pris en charge pour un abcès du sein. Nous avions colligé 41 dossiers de patients tous de sexe féminin. L’âge moyen était de 31 ans. Le principal facteur de risque objectivé était la mastite au cours de l’allaitement (27%). Le délai moyen d’évolution était de 12 jours avec des extrêmes de 1 et 30 jours. L’abcès siégeait à gauche dans 61% des cas et se présentait le plus souvent sous la forme d’une tuméfaction inflammatoire (88%). Les quadrants supérieurs étaient le plus souvent concernés (43,9%). L’échographie mammaire était réalisée chez 51,2% des patientes. Le drainage chirurgical sous anesthésie générale était réalisé chez toutes les patientes. La quantité moyenne de pus était de 119 cc. Le germe le plus fréquemment isolé était le Staphylococcus aureus (79,5%). La durée moyenne d’hospitalisation était de 7 jours et la morbidité opératoire de 31,7%. La mortalité était nulle. La prévention des abcès lactants passe par l’enseignement des méthodes d’allaitement et l’antibiothérapie précoce en cas de mastite.
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Affiliation(s)
- Magatte Faye
- Service de Chirurgie Générale, Hôpital Principal de Dakar, Dakar, Sénégal
| | - Birame Ndiaye
- Service de Chirurgie Générale, Hôpital Principal de Dakar, Dakar, Sénégal
| | | | - Ibrahima Sall
- Service de Chirurgie Générale, Hôpital Principal de Dakar, Dakar, Sénégal
| | | | - Oumar Fall
- Service de Chirurgie Générale, Hôpital Principal de Dakar, Dakar, Sénégal
| | - Alamaso Sow
- Service de Chirurgie Générale, Hôpital Principal de Dakar, Dakar, Sénégal
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Cobo F, Guillot V, Navarro-Marí JM. Breast Abscesses Caused by Anaerobic Microorganisms: Clinical and Microbiological Characteristics. Antibiotics (Basel) 2020; 9:antibiotics9060341. [PMID: 32570867 PMCID: PMC7345347 DOI: 10.3390/antibiotics9060341] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/04/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022] Open
Abstract
The objectives of this study were to report the antimicrobial susceptibility of 35 clinically significant anaerobic bacteria isolated from breast abscesses between March 2017 and February 2020 in a tertiary hospital in Granada (Spain) and to describe key clinical features of the patients. Species identification was performed mainly by MALDI-TOF MS. Antimicrobial susceptibility tests were carried out against benzylpenicillin, amoxicillin-clavulanic acid, imipenem, moxifloxacin, clindamycin, metronidazole, and piperacillin-tazobactam using the gradient diffusion technique and European Committee on Antimicrobial Susceptibility Testing EUCAST breakpoints (except for moxifloxacin). The most frequent anaerobes were Finegoldia magna (31.4%; n = 11), Actinomyces spp. (17.1%; n = 6), Propionibacterium spp. (17.1%; n = 6), and Prevotella spp. (14.2%; n = 5). Imipenem, amoxicillin-clavulanic acid, and piperacillin-tazobactam were universally active against all genera tested. High overall resistance rates to clindamycin were observed, especially for Gram-positive anaerobic cocci (56.2%) and Gram-positive anaerobic bacilli (38.4%). High resistance rates to metronidazole were also observed for Gram-positive (76.9%) and Gram-negative anaerobic bacilli (50%). High resistance rates to moxifloxacin were found for Gram-negative anaerobic bacilli (50%) and Gram-positive anaerobic cocci (31.2%). No breast abscess cases of Bacteroides spp. were detected. Routine antimicrobial susceptibility testing for anaerobes in breast abscesses may contribute to allow empirical therapies to be selected in accordance with local data on resistant strains.
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Affiliation(s)
- Fernando Cobo
- Correspondence: ; Tel.: +34-958-020-364; Fax: +34-958-241-245
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[Idiopathic granulomatous mastitis associated with erythema nodosum]. Ann Dermatol Venereol 2020; 146:571-576. [PMID: 31151772 DOI: 10.1016/j.annder.2019.04.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 12/24/2018] [Accepted: 04/08/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Idiopathic granulomatous mastitis (IGM) is a rare, chronic, granulomatous, inflammatory disorder with potentially misleading clinical and radiological features. IGM is diagnosed after exclusion of infectious or tumoral diseases. Herein we report a case of erythema nodosum associated with IGM, which serves as a reminder that erythema nodosum may constitute an extra-mammary sign of IGM. PATIENTS AND METHODS A 36-year-old nulliparous woman presented with fever and skin rash at our dermatology clinic at the North Franche-Comté hospital in July 2017. Symptoms had occurred 2 days previously. The patient had a fever of 38.8°C and typical erythema nodosum on the limbs. Physical examination showed an irregular, inflammatory, abscessed mass measuring 20cm with multiple shrinkage zones that had been developing for 4 weeks and for which breast examinations were being performed. Laboratory tests showed an inflammatory state (CRP 155mg/mL, WBC 14.6×109/L), other tests (serum electrolytes and calcium, hepatic and renal tests, Streptotest, T-spot, HIV, HBV, HCV serology, anti-streptolysin, anti-streptodornase, local microbiology samples, antinuclear antibodies, soluble antigens antibodies, hemocultures, angiotensin-converting-enzyme and chest x-rays) were normal. Microbiology investigations were negative. Mammography revealed invasive mastitis. Breast sample biopsies showed giant cell granulomas without caseous necrosis or tumor cells, and histochemical staining (PAS, Ziehl, Grocott, Gram) was negative. The final diagnosis was of IGM associated with erythema nodosum. Symptoms rapidly improved with oral steroids. DISCUSSION As reported herein, erythema nodosum may be associated with IGM and support the diagnosis thereof. This association is rare, with fewer than 30 case reports described in the literature. IGM is an uncommon benign disorder of the breast that can mimic two frequent breast disorders: breast carcinoma and breast abscess. It usually occurs in young sexually active women. It appears as a tumor with an inflammatory solid painful mass, with nipple and skin retraction, occasionally with abscesses and accompanied by homolateral axillary lymphadenopathies. Radiologic findings are usually not specific for or suggestive of cancer. The histopathological picture of IGM is characterized by the presence of multinucleated giant cells and epithelioid histiocytes forming non-caseating granulomas around lobules. Minor ductal and periductal inflammation is usually present. IGM is rarely associated with autoimmune system manifestations, especially erythema nodosum, arthritis, episcleritis or hidradenitis suppurativa. Although the physiopathology of IGM remains unclear, this case serves as additional evidence that the etiology of IGM is of autoimmune origin. While there is no recommendation for the treatment of IGM, oral steroids remain the cornerstone of therapy. CONCLUSION We report a case of IGM associated with erythema nodosum. Dermatologists must be aware of this association.
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Hu J, Huang X. Combining ultrasonography and mammography to improve diagnostic accuracy of plasma cell mastitis. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2020; 28:555-561. [PMID: 32333573 DOI: 10.3233/xst-190607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate the diagnostic value of ultrasonography and mammography for plasma cell mastitis. METHODS The ultrasonographic and mammographic images of 111 women with histopathologically confirmed plasma cell mastitis were retrospectively analyzed. The diagnostic accuracy of the two imaging methods was compared. RESULTS Ultrasonography identified 91 out of 111 (82.0%) patients with plasma cell mastitis, while the other twenty (18.0%) patients were misdiagnosed. Mammography identified 83 (74.8%) out of 111 patients with plasma cell mastitis. Nineteen (17.1%) patients were misdiagnosed. There was no significant difference between the diagnostic accuracy of using two imaging tests (P = 0.127). Mammography clouds identified 11 out of 20 patients who were not diagnosed by ultrasonography. Meanwhile, 19 of the 28 cases misdiagnosed with mammography were correctly identified by ultrasonography. Overall, 91.9% (102/111) of the patients were identified by the combination of ultrasonography and mammography, which yielded statistically significant higher accuracy than using each single test only (P < 0.05). CONCLUSIONS In diagnosis of plasma cell mastitis, high-frequency ultrasonography and mammography should be combined to improve the diagnostic accuracy.
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Affiliation(s)
- Jun Hu
- Department of Ultrasound, Chonggang General Hospital, Chongqing, China
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoling Huang
- Department of Ultrasound, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Dabi Y, Darrigues L, Pons K, Mabille M, Abd alsamad I, Mitri R, Skalli D, Haddad B, Touboul C. Incidence of inflammatory breast cancer in patients with clinical inflammatory breast symptoms. PLoS One 2017; 12:e0189385. [PMID: 29261724 PMCID: PMC5738061 DOI: 10.1371/journal.pone.0189385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/27/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND To describe a large cohort of women with non-puerperal inflammatory breast and to identify characteristics of inflammatory breast cancer. METHODS All patients consulting for inflammatory breast syndrome in the breast unit of our tertiary University hospital between September 2013 and December 2015 were prospectively included. We excluded women who were pregnant or in the postpartum period. Patients underwent systematic clinical examination and imaging (breast ultrasonography and mammography). A biopsy was performed if the clinician suspected a malignant lesion of the breast. Clinicopathologic and radiologic data were registered. Statistics were performed using R (3.0.2 version) software. RESULTS Among the 76 patients screened and included, 38 (50%) had a malignant lesion at final diagnosis, 21 (27.6%) were diagnosed with infectious disease and 17 (22.4%) with inflammatory disease of the breast. When compared to patients with benign disease, patients with a malignant lesion were significantly older (p = 0.022, CI95% 1.78-14.7), had a significantly bigger palpable mass (p<0.001, CI 95% 22.8-58.9), were more likely to have skin thickening (p = 0.05) and had more suspicious lymph nodes at clinical examination (p<0.001, CI 95% 2.72-65.3). Precise limits on ultrasonography were significantly associated with benign lesions. The presence of a mass (p = 0.04), micro calcifications (p = 0.04) or of focal asymmetry (p<0.001, CI95% 1.3-618) on mammography was significantly associated with malignant disease. CONCLUSION Inflammatory breast cancer was common in our cohort of women consulting for inflammatory breast syndrome. Identifying these patients with high-risk malignancy is crucial in the management of an inflammatory breast.
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Affiliation(s)
- Yohann Dabi
- Faculté de médecine de Créteil UPEC–Paris XII, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier Intercommunal de Créteil, Créteil–France
| | - Lauren Darrigues
- Faculté de médecine de Créteil UPEC–Paris XII, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier Intercommunal de Créteil, Créteil–France
| | - Kelly Pons
- Faculté de médecine de Créteil UPEC–Paris XII, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier Intercommunal de Créteil, Créteil–France
| | - Mylène Mabille
- Service de radiologie, Centre Hospitalier Intercommunal de Créteil, Créteil–France
| | - Issam Abd alsamad
- Service d’anatomopathologie, Centre Hospitalier Intercommunal de Créteil, Créteil—France
| | - Rana Mitri
- Service d’anatomopathologie, Centre Hospitalier Intercommunal de Créteil, Créteil—France
| | - Dounia Skalli
- Faculté de médecine de Créteil UPEC–Paris XII, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier Intercommunal de Créteil, Créteil–France
| | - Bassam Haddad
- Faculté de médecine de Créteil UPEC–Paris XII, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier Intercommunal de Créteil, Créteil–France
| | - Cyril Touboul
- Faculté de médecine de Créteil UPEC–Paris XII, Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Centre Hospitalier Intercommunal de Créteil, Créteil–France
- UMR INSERM U965: Angiogenèse et Recherche translationnelle, Hôpital Lariboisière, Paris, France
- * E-mail:
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12
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Tchaou M, Darre T, Amavi AK, Kanassoua KK, N'Timon B, Sonhaye L, Agoda-Koussema LK, Adjenou K. Breast Abscessed Cancer in Nonlactating Women in Tropical Environment: Radiological, Bacteriological, and Anatomopathological Features about 3 Cases. Case Rep Radiol 2017; 2017:1639847. [PMID: 28932615 PMCID: PMC5591997 DOI: 10.1155/2017/1639847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 07/25/2017] [Indexed: 11/21/2022] Open
Abstract
The association of breast cancer and abscess is rare in daily practice. The authors report a short series of 3 cases of cancer of the breast in nonlactating women presented as breast abscess, reviewing aspects in radiology (ultrasound and mammography), correlating them with the histopathology findings and the bacteriological profile of the isolated germs.
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Affiliation(s)
- Mazamaesso Tchaou
- University Teaching Hospital of Lomé, Department of Radiology, Lomé, Togo
| | - Tchin Darre
- University Teaching Hospital of Lomé, Department of Pathology, Lomé, Togo
| | - Ayi Kossi Amavi
- University Teaching Hospital of Lomé, Department of General Surgery, Lomé, Togo
| | | | - Bidamin N'Timon
- University Teaching Hospital of Lomé, Department of Radiology, Lomé, Togo
| | - Lantam Sonhaye
- University Teaching Hospital of Lomé, Department of Radiology, Lomé, Togo
| | | | - Komlavi Adjenou
- University Teaching Hospital of Lomé, Department of Radiology, Lomé, Togo
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13
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Lavoué V, Fritel X, Antoine M, Beltjens F, Bendifallah S, Boisserie-Lacroix M, Boulanger L, Canlorbe G, Catteau-Jonard S, Chabbert-Buffet N, Chamming's F, Chéreau E, Chopier J, Coutant C, Demetz J, Guilhen N, Fauvet R, Kerdraon O, Laas E, Legendre G, Mathelin C, Nadeau C, Naggara IT, Ngô C, Ouldamer L, Rafii A, Roedlich MN, Seror J, Séror JY, Touboul C, Uzan C, Daraï E. Clinical practice guidelines from the French College of Gynecologists and Obstetricians (CNGOF): benign breast tumors – short text. Eur J Obstet Gynecol Reprod Biol 2016; 200:16-23. [DOI: 10.1016/j.ejogrb.2016.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/11/2016] [Indexed: 10/22/2022]
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